Breast examination :-

‫سالم عليكم انا طالب … عندي امتحان مهارات بعد اذنك نبي‬
‫نفحصلك الثدي‬
Privacy :- ‫لو انت دكتور بتجيب معاك ممرضه‬
Position :- setting during inspection and in 45
during palpation
Exposure :-upper neck to umbilicus and axially
are must be exposed
‫ بتقول مش نشوف ف حالة فيه‬umbilicus ‫مرات يقولك عالش ل‬
metastasis
——————————-
By inspection
Both breast looks symmetrical or not
Example the left breast look larger than right
side
Both nipple in same direction or not
Nipple :- retracted or protected
Example there is retracted nipple in left side
without discharge
Ask patient to elevate her breast to see retro
mammary area for fungal infection
Any colour changes , scar or skin manifestation
like pudo-orange mainly in retro-mammary area
indicate carcinoma
Any mass example
in ULQ ,oval in shape , 2-3cm skin over mass
looks normal no pigment no ulcer

——————-
Palpation
Position :-45
‫*نسال املريضه هل عندك اين مكان يوجع فيك؟‬
exposing to ‫نطلب منها تحط ايدها تحت راسها مش ندير‬
axillary thail

Wash my hand
Start with normal breast
*Ask patient to do squeeze nipple
7 area of breast :-
1-Upper outer / lateral quadrant
2-upper medial quadrant
3-lower outer / lateral quadrant
4- lower medial quadrant
5-nipple and areolar
6- retro mammary area
7- axillary thail
By circular movement or every quadrant alone
If u nd mass u should mention about :-
Example :-
Site:- in nipple areolar
Size :-5*3cm
Irregular oval mass
Hard in consistency
Not attached to skin
‫اهني نطلب منها ادير ايدها ف خسرها وتشحط كتافها نعلق‬
👇 ‫ونقول‬
(Attached to underling structure )
*Which most like malignant mass
Last step exam the axillary thail
Finally u have to do
axially lymph nodes , respiratory ,GIT
examination

2 special test :-
‫نطلب من املريضه تحط يديها ف خسرها‬-1
dumpling ‫ مش نشوف لو فيه‬lying for word ‫و‬
‫ وتاني شي نطلب منها انها تحط ايدها ع راسها مش ندير‬-2
expositing to axillary thail
Cover and thanks to the patient