1. Introduction
The breast examination is used to assess lumps, skin change, nipple symptoms and axillary lymphadenopathy. This is a sensitive examination and should be performed only with appropriate consent, a chaperone and careful attention to dignity.
2. Inspection
Inspect with the patient seated and appropriately exposed. Look with the arms relaxed, raised above the head and pressing hands on hips to tense the pectoral muscles. Note asymmetry, skin dimpling, erythema, peau d''orange, scars, nipple inversion and visible masses.
3. Palpation
Palpate each breast systematically with the flat of the fingers including the tail of Spence. If a lump is found, describe its site, size, consistency, tenderness, mobility and relation to skin or chest wall. Gently assess the nipple and check for discharge only if clinically indicated.
4. Lymph nodes and completion
Palpate the axillary, supraclavicular and infraclavicular lymph nodes. To complete the examination, offer a chest examination if malignancy is suspected and arrange appropriate imaging and specialist review.
Preparation
Inspection
Palpation
Lymph nodes
Completion