Breast examination

Question 1

Is self breast examination useful in screening for breast cancer?

Answer 1

No, it can be recommended as a tool for self-awareness, but it does not lower breast cancer mortality rates.

Question 2

Is the clinical breast examination useful?

Answer 2

Yes, it can detect some malignancies not detected with mammograpy and in younger women who are not candidates for mammography.

Question 3

How often is donde the clinical breast examination?

Answer 3

• 1-3 years => Between 20-39 years

* Annually => From 40 years

Question 4

Position for breast inspection?

Answer 4

The woman sits on the table’s edge with her hands pressed against her hips => This position enhances any assimmetry that can arise from any tumour/mass

Question 5

Which other position during inspection is useful?

Answer 5

No one, additional arm positions, such as placing arms above the head, do not add vital information

Question 6

What is searched during breast inspection?

Answer 6

• Skin: erythema, retraction, scaling (especially over the nipple), and edema (peau d’orange)
• The breast and axilla are also observed for contour symmetry

Question 7

What follows inspection?

Answer 7

Lymph nodes palpation

Question 8

Which nodes are seek during palpation? (3)

Answer 8

• Axillary
• Supraclavicular
• Infraclavicular

Question 9

Which position should be adopted for lymph node palpation?

Answer 9

Patient seated with her arm supported by the examiner

Question 10

How is done the palpation of the axillary lymph nodes?

Answer 10

The hand glides from high to low in the axilla and momentarily compresses nodes against the lateral chest wall.
*In a thin patint 1 or more normal, mobile lymph nodes <1cm in diameter may be appreciated.

Question 11

First lymph node (sentinel node) to become involved with breast cancer metastasis?

Answer 11

Nearly always located just behind the midportion of the pectoralis major muscle belly

Question 12

Which position should be adopted for breast palpation?

Answer 12

Woman supine with one hand above her head to stretch tissue across the chest wall

Question 13

What is the technique used in breast palpation?

Answer 13

Using the finger pads in a continuous rolling, gliding circular motion.
At each palpation point, tissues is assessed both superficially and deeply.
*Recommended to do up and down (linear)

Question 14

When is required intentional attempts at nipple discharge?

Answer 14

NOT required unless a SPONTANEOUS discharge has been described by the patient

Question 15

How should be described any findings on breast examination?

Answer 15

• Location: Right or left breast; clock position; and distance from areola.
• Size

Question 16

Is it better to do the breast examination before or after the menstrual cycle? Why?

Answer 16

*The breast change with the menstrual cycle, and after the menstrual cycle is the time where the changes are least