Assessing Breast and Lymph Nodes

PROCEDURE
4 3 2 1
1. Gather equipment
2. Identify the client with 2 identifiers.
3. Introduce yourself and explain the procedure to the client.
4. Provide privacy and call chaperone (if needed).
5. Perform handwashing and ask permission for the procedure.
6. Ask the client to put gown.
Inspection of breast
1. Place Client in Sitting position and ask to lower his/her gown.
2. Size and symmetry
3. Color and Texture
4. Superficial Venous pattern
5. Retraction and Dimpling
(a)Raise both arms over head
(b)Then lower arm and pressed against the hip
(c) Presses the hands together with the fingers of one hand pointing opposite to the fingers
of the other hand
(d) Raise both arm laterally
(e)Forward leaning position
6. Bilaterally; note color, size, shape, and texture of areolas
7. Bilaterally; Note size and direction of nipples
Palpation of Breast
1. Place the Client in supine/sitting position. Slightly in Akimbo position to expose the
Quadrant of the breast. And ask permission for palpation.
2. Palpate one breast at a time and start on good/unaffected breast first. Use either Circular,
wedge or Vertical strip method.
3. Palpate Texture and elasticity
4. Palpate for tenderness and temperature
5. Palpate for masses.
Note location, size in cm, shape mobility, consistency and tenderness. Also note condition of the skin
over the mass.
6. Palpate Nipples by compressing nipple gently between thumb and index finger; observe
for discharge.
7. Palpate mastectomy site; if applicable, observing the scar and any remaining breast or
axillary tissue for redness, lesions, lumps, swelling, or tenderness.
Axillary and Supraclavicular
1. Inspect for rashes or infection
2. Hold the elbow with one hand and use the 3 finger pads of your other hand to palpate
firmly the axillary and supraclavicular lymph nodes.
3. Palpate high into the axillae, moving downward against the ribs to feel for central nodes.
Continue down the posterior axillae to feel for posterior nodes. Palpate supraclavicular
area also and note for any lymph nodes, note for its size.
4. Use bimanual palpation to feel for the anterior axillary nodes.
5. Palpate down the inner aspect of the upper arm.
 Analysis Of data
1. Perform handwashing
2. Document the procedure.

Name ____________________________________________ Score______________________

Year and Section___________________________________ Clinical Instructor_____________

SCALE:
4 – Exemplary (Competent and Independent)
3 – Proficient ( Requires minimum guidance)
2 – Satisfactory (Requires frequent guidance)
1 – Developing (Requires close guidance)