Female Breast Examination

Patient Preparation
1) 2) 3) 4) 5) 6) GIEP Uncomfortable, Not painful, Few minutes at most. Permission, Questions ? Chaperone Remove clothing & bra to fully expose chest. *Use a drape to limit exposure !!

Procedure
1) Wash Hands !!!! 2) General Inspection Alert, Well, Comfortable, No respi distress, Not in obvious pain, Not cachexic.

3) Inspection 2.1) Patient Sits up.

1. Breast Symmetry 1) Size [Equal both sides ] 2) Shape [Normal shape No mass/ swelling ] 3) Symmetrical (nipple position) Skin Condition 4) Scars Mastectomy 5) Colour Change 6) No dimpling 7) Visible veins 8) Peau dorange 2. Nipples 1) 2) 3) 4)

[No discolouration, Pinkish (normal), No redness,]

Shape - normal cylindrical Retraction Cracks Discharge

2.2) Patient Raise arms & Lower them slowly

1) Tethering 2) Change in relative position of nipples 3) Distortion of breasts

2.3) Patient Rest hands on hips & Press down

1) Fixation 2) Dimpling 3) Palpate Breast 1. Patient Lie down- Palpate 4 quadrants & periareolar region (Examine in concentric circular pattern) 1) Tenderness ? 2) Position, Size, Shape 3) Palpable masses 4) Feel behind nipples for any lumps 2. Note if any fluid expressed - Blood, Serous, Milky, Green

4) Palpate Axilla
1. Palpate Axillary regions (bilaterally) for lymphadenopayhy . 5) Thank pt, Ask her dress . 6) Explain findings.

Possible follow-up investigations

1) Biopsy / Fine Needle Aspiration / Cytology 2) Mammography / Ultrasound .

Indications
1. Screening for Breast cancer or when Breast cancer suspected. 2. Symptoms of breast disease (e.g. lump / nipple discharge / skin changes ) 3. Unexplained weight loss.