Breast Examination

Question 1

How would you open the consultation?

Answer 1

introduce myself and say why im there
identify them
the breast exam will include looking at the shape of and skin round the breasts and feeling the breast tissue and finally examining a few of your lymph nodes
it shouldn’t be painful at any point but if you do feel any discomfort please let me know
we have a chaperone here for your comfort
would you mind undressing to the waist
here’s a blanket to cover yourself

Question 2

what are the components of the breast exam

Answer 2

general inspection
palpation
lump examination if required
axilla
lymph nodes

Question 3

how do you carry out the general inspection?

Answer 3

sit up, hands by side
look for asymmetry, swelling, masses
skin and nipple changes

inspect with hands on hips
tense pec major

inspect with hands behind head
lean forwards

Question 4

how do you palpate the breast?

Answer 4

bed at 45
hand on side being examined behind head, over by the side
using the flat of first three fingers use a spiral motion away from the nipple
feel the axillary tail between thumb and fingers

if you find a mass do the rest and then come back
if they report discharge from the nipple get them to give it a squeeze

Question 5

how do you examine the axilla

Answer 5

edge of bed facing you
support arm
5 points

Question 6

how do you do the lymph node exam

Answer 6

cervical

supra and infraclavicular

Question 7

what do you look for when examining a lump?

Answer 7

position - quadrant, how far from nipple
size and shape
consistency
overlying skin
mobility
fluctuance