Breast Examination

Question 1

How do you start a breast examination?

Answer 1

Ensure you have a female chaperone present
Ask patient to remove her clothes down to the wait and sit on edge of bed
Ask patient which side the problem is and if there’s any pain

Question 2

What positions do you inspect the breast from?

Answer 2

At rest
With both arms raised above head
Sitting and pushing body off the bed with both hands
Putting hands on hips and pushing inwards
Lean forward (muscle tethering)

Question 3

What are you looking for in inspection of the breast?

Answer 3

Dimpling
Peau d'orange
Nipple retraction
Scars
Discharge

Question 4

What position do you palpate the breasts in?

Answer 4

45º relaxed back with head on pillow and arm above head

Question 5

Explain how to palpate

Answer 5

Start with normal breast %w/pt’s hand behind head
Palpate 4 quadrants with flat of fingers
Feel area underneath areolar and nipple
Feel axillary breast tail tissue while holding weight of pt’s arm
Feel axilla for lymph nodes
Repeat on other breast
If discharge, ask patient to produce it
Check supraclavicular lymph nodes from behind
Bony tenderness/listen to lungs/hepatomegaly/splenopmegaly

Question 6

How do you describe lumps?

Answer 6

Size, location, shape, colour
Tenderness, temperature
Consistency
Surface (smooth/irregular)
Well defined/ill defined
Tethering/mobility
Overlying skin changes

Question 7

Name 4 common benign reasons for breast lumps

Answer 7

Fibroadenoma
Fibrocystic change
Sebaceous cyst
Acute mastitis/abscess (esp breast feeding/smoking)