Breast Assessment:
4 Breast quadrants:
1. Upper outer
2. Upper inner
3. Lower outer
4. Lower inner
Inspection of the breast: Inspect the Breasts,
Axillae, Nipple, and Areolar for color,
vascularity, thickening, edema, size, symmetry,
contour, lesions or masses, and discharges.
Procedure:
1. Sitting position, uncover to waist, facing
you
2. Arms relax by her side
3. Inspect breast, axillas, areolar areas,
nipples for color, vascularity,
thickening, edema, size, symmetry,
contour, lesions, masses, exudates
4. Repeat above inspections with arms
raised over head
5. Repeat with pt pressing hips
6. Repeat with pt leaning forward
Normal:
1. Color = Breast & axillae are flesh
colored, areola & nipple are darker
2. Moles & nevi are normal variants
3. Terminal hair may be present in areola
Abnormal:
1. Striae
Assess for:
1. Vascularity:
-Observe entire surface of each breast
for superficial vascular patterns
Normal superficial patterns are diffuse
and symmetrical
Abnormal: focal or unilateral
vascularity
2. Thickening or edema
- Observe breast, axillae and nipple for
thickening or edema
Normal: Not found
Abnormal:
1. Peau d orange enlarged skin
pores.
3. Size & symmetry
- Observe breast, axillae and nipple for size &
symmetry
Abnormal:
1. Asymmetry in directions, dimpling
4. Contour
- Assess breast for contour, compare to each
other
Normal: Convex, without flattening, retraction
or dimpling
5. Lesions/masses
Normal: no masses, lesions, tumors
Abnormal:
a. Pagets disease-persistent eczematous
dermatitis of areola & nipple region
6. Discharge
Palpation of the breast:
Procedure:
1. Performed in sequential manner
2. Supraclavicular & infraclavicular lymph
node areas
3. Breast (Sitting-arms at side-arms raised
over head)
4. Axillary lymph node regions
5. Breasts (Supine)
Palpate the ff:
1. Supraclavicular & infraclavicular lymph node
areas
- Pt seated; uncover to waist
- Encourage to relax muscles of head & neck
- Flex head to relax SCM
- Stand in front, in bilateral & simultaneous
motion, place finger pads over pts clavicle,
lateral to the tendinous portion of the SCM
- Using a rotary motion of palmar surface of
fingers, probe deeply into scalene triangles to
palpate supraclavicular lymph nodes
- Palpate infraclavicular nodes using same
rotary motion of palmar surface of fingers.
Normal: Palpable lymph node <1cm in
diameter (No pain)
Abnormal: Fixed, firm, immobile, irregular
lymph node >1cm
Abnormal: Enlarged, painful, or tender nodes
that are matted together

2. BREAST
- Pt seated; arms at side
- Stand at right side, face pt
- Using palmar surface of fingers of dominant
hand, begin palpation at upper quadrant of
right breast
- Use other hand to support the inferior aspect
of breast (pendulous: bimanual palpation)
- Palpate in downward fashion, sweeping from
outer quadrants to sternal border of each
breast
- Repeat: other breast
- Repeat: arms raised over head

Normal: consistency is variable, depending on

age, time in menstrual cycle, & proportion of
adipose tissue
Should not be tender although it may become
full & slightly tender premenstrually

Abnormal:
a. Mastitis swelling of breast

3. Axillary lymph node

Locate & palpate the 4 axillary lymph node
groups
a. Brachial (lateral) at the inner aspect of
upper part of humerus, close to axillary
vein
b. Central axillary (midaxillary) at the
thoracic wall of axilla
c. Pectoral (anterior) behind the lateral
edge of pectoralis major muscle
d. Subscapular (posterior) at the anterior
edge of the latissimus dorsi muscle
*concentric, parallel & wedge
*perform BSE regularly