LESSON PLAN ON BREAST SELF
EXMINATION
1. Topic
2. Batch
3. Duration
4. List of A.V aids
5. No of Participants
6. Name of the student Teacher
7. Name of the supervising teacher
: Breast cancer and breast self-examination
: B.Sc. Nursing IIIrd Year
: 45 min
: Flash card on anatomy of breast
Flash card on risk factors
Chart on signs and symptoms
Chart on prevention
Chart on recommendation
Flipchart on other examination
Leaflet on positions used in breast-self examination
Leaflet on procedure for manual self-breast examination
Self-breast examination model for steps of self-breast examination
: 39
: Mr. Bharat Singh Banshiwal
:
8. Objectives
8.1 General objectives
At the end of the class Students will be able to,
i. acquire the knowledge regarding breast self- examination
ii. apply the knowledge in the daily life
iii. appreciate the importance of doing regarding breast self- examination

8.2 Behavioural objectives

At the end of the class the Students will be able to,
i. Define cancer
ii. Reviews the anatomy of breast
iii. Infers the incidence of breast cancer
iv. Identifies the risk factors of breast cancer
v. Enlist the signs and symptoms of breast cancer
vi. Classifies lumps found in the breast
vii. Enumerate the diagnosis of breast cancer
viii. Describe the prevention of breast cancer
ix. Explains the meaning of self-breast examination
x. Lists the recommendations for self-breast examination.
xi. List the other investigations along with self-breast examination
xii. Illustrates the position used for self-breast examination
xiii. Describe the procedure for manual self- breast examination
xiv. Demonstrate self-breast examination
Time Behavioural objectives Content Teaching Methods Av Learning Evaluation
aids activities

1/2min II. TOPIC INTRODUCTION Lecture cum Listen and

In the world there are different types of diseases. discussion contributes
Recently commonest and dreadful among them is
cancer. There are different types of cancer. Each got
its own surgeries and treatment. Now let’s see what
this breast cancer, its treatment and screening
method to detect breast cancer.

1min i. define III. DEFINITION Lecture cum Listen and What is the
Cancer is a malignant growth or tumor resulting from
cancer discussion contributes definition of
an uncontrolled proliferation or division of cells.
Cancer ?
Mainly there are two types of cancers: benign and
malignant Breast cancer is cancer that develops from
breast tissue.
 Signs of breast cancer may include a lump in the
breast, a change in breast
shape, dimpling of the skin, fluid coming from the
nipple, or a red scaly patch of skin. In those
with distant spread of the disease, there may
be bone pain, swollen lymph nodes, shortness of
breath, or yellow skin.

2min ii. Reviews the IV. ANATOMY OF BREAST Lecture cum Flash Listen and How many
cards
anatomy of Breasts are modified sweat glands that produce discussion contributes lobes does
breast milk. They lie over the chest muscle and are What is sweat each breast
attached to it by a layer of connective tissue. The gland? have?
breasts consist of 15 to 20 lobes or compartment
separated by fat tissue The amount of fat determines
the size of the breasts. Each lobe has several small
 compartments called lobules composed of tissues
embedded with milk secreting glands termed as
alveoli. The milk produced from the alveoli is
conveyed to lactiferous ducts. As the mammary
glands approach the nipple, they expand to form
sinuses where the milk is stored. These sinuses
continue as lactiferous ducts that terminate in
pigmented portion called nipple. The circular
pigmented area of the surrounding the nipple is
called the areola.

4min iii. Infers the V. BREAST CANCER Lecture cum Listen and
incidence of 5.1 INCIDENCE discussion contributes
breast Breast cancer is the second leading cause of
cancer cancer related to death among women. It can occur
anytime after menarche but rarely before 20 years
of age and primarily after 40 years of age.
8min iv. Identifies 5.2 RISK FACTORS Lecture cum Flash Listen and What are the
cards
the risk The risk factors are: discussion contributes risk factors
factors of 5.2.1 Family history of breast cancer associated
breast 5.2.2 Early menarche with breast
cancer 5.2.3 Nullipara cancer?
5.2.4 First pregnancy in advanced age
5.2.5 Women who have never breastfed their
infant
5.2.6 Obesity
5.2.7 Increased fat consumption
5.2.8 Oral contraceptive use
5.2.9 High dose radiation exposure
12min v. Enlist the 5.3 SIGNS AND SYMPTOMS Lecture cum Chart Listen and What all are
signs and The signs and symptoms are: discussion contributes the signs and
symptoms of 5.3.1 Breast become larger What is the first symptoms of
breast 5.3.2 Nipple become innervated noticeable breast cancer?
cancer 5.3.3 Rashes around the nipple symptom of breast
5.3.4 Discharge from nipple cancer?
5.3.5 Pain in the part of breast
5.3.6 Lump

13min vi. Classifies 5.4 CLASSIFICATION OF LUMPS FOUND IN Lecture cum Self Listen and Which kind of
breast
lumps found BREAST discussion contributes cancer is
exami
in the breast The lumps found in the breast classified into nation painfull?
model
I. Benign breast cancer
II. Cancerous breast cancer
Benign breast cancer: These are non cancerous
lump found in breast.
Cancerous breast cancer: These are painless, non
tender, hard irregular shaped and non mobile
masses.
16min vii. Enumerate 5.4 DIAGNOSIS Lecture cum Listen and What all are
the 5.5.1 Mammography discussion contributes the diagnostic
diagnosis of 5.5.2 Breast self examination studies of
breast 5.5.3 Biopsy breast cancer?
cancer 5.5.4 Additional test like ultrasound or MRI

21min viii. Describe the 5.6 PREVENTION Lecture cum Chart Listen and How can we
prevention 5.6.1 Limit alcohol discussion contributes prevent breast
of breast 5.6.2 Don't smoke cancer?
cancer 5.6.3 Control your weight
5.6.4 Be physically active
5.6.5 Breast-feed
5.6.6 Limit dose and duration of hormone therapy
5.6.7 Avoid exposure to radiation and
environmental pollution
22min ix. Explains the VI. BREAST-SELF EXAMINATION Lecture cum Listen and What is self
meaning of Breast-self examination (BSE) is a screening discussion contributes breast
breast-self method used in an attempt to detect early breast examination?
examination cancer. The method involves the woman herself
 looking at and feeling each breast for possible
lumps, distortions or swelling.

25min x. Lists the 6.1 RECOMMENDATION Lecture cum Chart Listen and When should
recommenda 6.1.1 Women should start practicing breast-self discussion contributes breast-self
tions for examination by 20 years of age. What is examination
breast-self 6.1.2 In menstruating women best time for doing hysterectomy? be practice in
examination. breast-self examination is the last day of lactating
menstruation women?
6.1.3 In the post menopausal women and those
who had hysterectomy should do breast-self
examination every month on the same day.
6.1.4 In pregnant women breast-self examination
should be done on every month on the same
day; preferably on the first day of each
month.
6.1.5 In lactating women, the breast should be
done on every month but after feedings
when breast are empty.
 6.1.6 In older women breast should be examined
on the monthly basis: Preferably on the first
day of each month.

27min xi. List the other 6.2 OTHER EXAMINATIONS; Lecture cum Flip Listen and What is
chart
investigations 6.2.1 Clinical breast examination: discussion contributes mammogram?
along with a) For a woman between 20 – 40 years What is breast
breast-self of age, clinical breast examination cancer?
examination should be done on every 3 years.
b) For a woman of 40 years of age,
should be done every year.
c) For a woman with positive family
history of breast cancer should be
done every year.
6.2.2 Mammogram:
a) It should be done by a women by the
age of 40 years
b) For a woman between 40-49 years of
age, should be performed once in
 two year.
c) For asymptomatic women above 50
years of age, mammogram should be
done every year.

29min xii. Illustrates 6.3 POSITIONS USED FOR BREAST-SELF Lecture cum leaflet Listen and Which all are
the position EXAMINATION: discussion contributes the positions
used for 6.3.1 In front of the mirror used for breast-
breast-self  Arms at side self
examination  Hands clasped behind the head examination?
and press the hand forward.
 Hands pressed firmly on the hips
6.3.2 Lying down
6.3.3 Under the showers

35min xiii. Describe the 6.4 PROCEDURE FOR MANUAL SELF Lecture cum Leafl Listen and What are the
et
procedure BREAST EXAMINATION: discussion contributes benefits of
for manual Breast-self examination is a cost effective, 1. What is self breast
self breast early detection method as it requires no special dimpling? examination?
examination equipment, needs no special appointment with a 2. What is
health professional, and could be done in the puckering?
privacy of one’s home according to the
convenience. What is first
Step 1: Begin by looking at your breasts in the step in self
mirror with your shoulders straight and your arms breast
on your hips. examination?
 Here's what you should look for:
 Breasts that are their usual size, shape, and
colour
 Breasts that are evenly shaped without
visible distortion or swelling
 If you see any of the following changes,
bring them to your doctor's attention:
 Dimpling, puckering, or bulging of the skin
 A nipple that has changed position or an
inverted nipple (pushed inward instead of
sticking out) Which part of

 Redness, soreness, rash, or swelling the hand is

used for
Step 2: Now, raise your arms and look for the same palpation?
changes.
Step 3: While you're at the mirror, look for any
signs of fluid coming out of one or both nipples
(this could be a watery, milky, or yellow fluid or
blood).
Step 4: Next, palpate your breasts while lying
down, using your right hand to palpate your left
breast and then your left hand to palpate your right
breast. Use a firm, smooth touch with the first few
finger pads of your hand, keeping the fingers flat
and together. Use a circular motion, about the size
of a quarter.
 Cover the entire breast from top to bottom,
side to side — from your collarbone to the
top of your abdomen, and from your armpit
to your cleavage.
 Follow a pattern to be sure that you cover
the whole breast. You can begin at the
 nipple, moving in larger and larger circles
until you reach the outer edge of the breast.
You can also move your fingers up and
down vertically, in rows, as if you were
mowing a lawn. This up-and-down approach
seems to work best for most women. Be
sure to feel all the tissue from the front to
the back of your breasts: for the skin and
tissue just beneath, use light pressure; use
medium pressure for tissue in the middle of
your breasts; use firm pressure for the deep
tissue in the back. When you've reached the
deep tissue, you should be able to feel down
to your ribcage.
Step 5: Palpate your breasts while you are standing
or sitting. Many women find that the easiest way to
feel their breasts is when their skin is wet and
slippery, so they like to do this step in the shower.
Cover your entire breast, using the same hand
movements described in step 4.
 Step 6: Squeeze the nipple if each breast to look for
discharge, bloody or spontaneous discharge.

41min xiv. Demonstrate VII. STEPS OF BREAST-SELF Lecture cum Self Listen and How many
breast
breast-self EXAMINATION ON MODEL discussion contributes imaginary
exami
examination STEP I: INSPECTION nation lines are used
model
1. Inspects the Breast-self examination model What is contour? to divide the
and detects abnormalities in the contour, breast into
shape and size of the breasts different
2. Divides the breast into quadrants by two quadrants?
imaginary lines.
STEP II : PALPATION
1. Verbalizes position used for breast-self Which part of
examination the hand is
2. Demonstrates the position of hands during used for
breast-self examination palpation?
3. Palpates breast with 3 or 4 finger pads
4. Keep the fingers flat and together to palpate
the breast
 5. Examine one breast at a time
6. Examines both the breast systematically
7. Palpate the breast from top to bottom
8. Palpate the breast from side to side (collar
bone to the top of the abdomen
9. Palpate the breast in a circular motion.
Begin at the nipple, moving in larger and
larger circles until reach the outer edge of
the breast
10. Uses light pressure to palpate skin and tissue
just beneath
11. Uses medium pressure for tissue in the
middle of breast
12. Uses firm pressure for the deep tissue
13. Squeezes the nipple to see any discharge
STEP II : REPORTING
1. Reports the abnormalities detected during
self-breast examination
43min xv. Summarizes VIII. SUMMARY
the topic Today we discussed on following topics,
a. Incidence of breast cancer
b. Anatomy of breast
c. Risk factors of breast cancer
d. Signs and symptoms of breast cancer
e. Prevention of breast cancer
f. Meaning of breast-self examination
g. Recommendations for breast-self
examination
h. Positions for breast-self examination
i. Procedure for manual breast-self
examination
j. Steps on breast-self examination model
45 min. IX. RECAPTUALIZATION
1. What is breast cancer?
2. What all are the signs and symptoms
of breast cancer?
3. What all are the risk factors of breast
cancer?
Which part of the hand is used for the
palpation of breast?
Thank You…