Gynaecology

Question 1

Topic 1

Answer 1

Examination of the breast and axillary nodes

Question 2

How would you start the breast examination?

Answer 2

WIPER

Wash hands
Introduce yourself
Patient details - must ask for at least 3. This includes full name, address, DOB, NHS no., hospital no.
Explain procedure
Risks - may feel pain/discomfort, can stop at any point

Gain consent. A chaperone must be present.
Patient to be undressed to the waist/ gown around shoulders for patient dignity.

Question 3

What signs would you look for when inspecting the breasts?

Answer 3

Patient sits on the couch facing you.
Observe the breast by looking for:

SAND
Skin tethering
Asymmetry
Nipple retraction
Discolouration

Ask the patient to lift her arms above her head and look again. Then ask her to put her hands on her hips and push in (to contract her pectoral muscles) and look again. This will make tethering more obvious.