Breast examination

Question 1

Breast inspection positions

Answer 1

1.Hands relaxed on the side
2.Hands behind head
3.Hands on hips
4.Hands in “praying” above head

Question 2

what are we inspecting (look) for breasting examination

Answer 2

• Symmetry
• skin changes: puckering, peaud’orange, ulceration
• Lump
• Colour
• Nipple

Question 3

Breast Palpation

Answer 3

1. 45° angle, arms behind head
2. Asymptomatic side 1st
3. circular motion 4 quadrants/tail/axilla

Question 4

what to note down for breast palpation

Answer 4

• Lump: Location, size, shape, consistency, fixity
• Nodularity
• Tenderness

Question 5

what to do if patient’s PC is nipple discharge

Answer 5

Ask pt to squeeze nipple
- note colour
- no. of ducts
- nipple cytology

Question 6

how to examine axilla lymph nodes

Answer 6

• Take weight of arm
• Four walls and apex
• Supraclavicular fossa (clavicular LN)
  Lymph nodes : Size, consistency, fixation

Question 7

OSCE further examination + Ix suggestions

Answer 7

• Abdo + Lumbar spine for ?met
• summary findings

Question 8

Examination findings grading

Answer 8

P1 – Normal tissue
P2 – Benign
P3 - Indeterminate
P4 – Probably malignant
P5 – Frankly malignant