Breast Exam Flashcards
WHAT DO YOU ASK FOR
CHAPERONE
If patient has presented due to concern about lump:
ASk about
Location of lump
Small scars
Lumpectomy
Large diagonal scars
Mastectomy
Asymmetrical breasts
Healthy breasts are often asymmetrical
Masses
Note the size and position
Look for overlying skin changes
Erythema
Healthy breast
Puckering
May indicate an underlying malignant mass
Peau d’orange
Cutaneous oedema
Inflammatory breast cancer
Retracted nipple
Congenital/underlying tumour/ ductal ectasia
Discharge in nipple
May indicate infection or malignancy
Rash/scale on nipple
May indicate eczema or Paget’s disease
When doing inspection, where are hands
1st round- arms by side
2nd round- hands on hips- ask patient to place hands on their hips and push inwards (to tense pectoralis major)
3rd round- arms above head
4th round- stay in position but lean fowards
When hands on hips and noting mass
If a mass is noted, observe to see if the mass moves with the pectoralis muscle (=tethering, suggestive of invasive malignancy)
Arms above head what do u do
Inspect breasts tissue for evidence of:
Masses
Asymmetry
Dimpling/puckering
What does leaning forwards do
Exacerbate any skin dimpling/puckering which may relate to an underlying mass
Which breast do u check first
Asymptomatic breast first
Yellow/green discharge
Infection
Duct ectasia
Bloody discharge
Malignancy
Papilloma
Position of lump
Quadrant of the breast
Clock face metaphor
How far away from the nipple
Size of lump
Approximate dimensions e.g. 2cm x 3cm
Shape of lump
Round
Elongated
Irregular
Consistency of lump
Smooth
Firm
Stony
Rubbery
Overlying skin changes over lump
Erythema
Puckering
Peau d’orange
Mobility with lump
Does it move freely
Does it move with overlying skin
Does it move with pectoral contraction
Fluctuance of lump
Hold the mass by both sides and apply pressure with another finger to the centre of the mass
If the mass is fluid-filled (e.g. cyst) then you should feel the sides bulging outwards
