Breast

Question 1

What should be done on general inspection (breast)?

Answer 1

• age
• cachexia

Question 2

What must be done on inspection (breast)?

and what are you looking for?

Answer 2

Position = sitting

4 actions:

• Arms relaxed
• Hands rested on thighs
• Hands actively pressed into hips (tenses pectorals)
• Hands behind head (to expose whole breast and accentuate dimpling)

Look for:

• asymmetry,
• local swelling,
• skin changes (erythema, dimpling, peau d’orange, scars), nipple changes (Paget’s disease of the breast, inversion)

Question 3

What must be done on palpation (breast)?

Answer 3

position = 30 degrees

check for pain

begin on normal side

pt’s arm on side of examination must be behind head

• massage using full hand in step-wise manor around breast - looking for lumps
• examine axillary tail between thumb and 2 fingers
• ask pt to squeeze nipple to produce any discharge
• lymph nodes: 1) axillary 2) supraclavicular

Question 4

How do you describe a lump found (breast)?

Answer 4

Describe any lump (SSSCCCTTT):

• Site,
• Size,
• Shape,
• Consistency,
• Contours,
• Colour,
• Tenderness,
• Temperature,
• (Transillumination)

Question 5

How would you complete your examination?

Answer 5

• Full Hx
• Imaging (ultrasound if <35y or mammogram if >35y)
• Tissue sampling (FNA if cystic or core biopsy if solid)