Breast Examination - A
Breast Examination - A
Breast Examination - A
References:
Physical Examination by Barbara Bates
Harrisons Principles of Internal Medicine, 17 th ed.
http://www.cancer.gov/cancertopics/factsheet/estimating-breast-cancer-risk#a2
Dr Paul Bradley, Clinical Skills Resource Centre, University of Liverpool, UK
UW Medical School's Patient, Doctor, and Society course for second year medical students
Objectives
1. Discuss general guidelines in the clinical
breast examination by a physician
2. Discuss the techniques in doing the
following:
General Guidelines
Male examiners should normally be chaperoned
Texture: smooth to granular
menstrual cycle and during pregnancy
Nodularity and tenderness often increase
towards the end of the cycle and during
menstruation
Asymmetrical so always examine both and
compare one to the other
Nipples
everted, flat, or
inverted (note if
recent change or
longstanding
cracking or
eczema
bleeding or
discharge
Nodules
Nipple
Discharge
Milky (hypothyroidism, prolactinoma, drugs)
Bloody (papilloma, Pagets disease)
UW Medical School's Patient, Doctor, and Society course for second year medical students
AXILLARY
The patients forearm is rested across the
examiners forearm
An alternative is to ask the patient to rest their
hand on the examiners shoulder
The examiner feels for each group of nodes, while
steadying the shoulder with the other hand
apical
anterior (posterior surface of anterior axillary fold)
medial (on the chest wall)
lateral (against the humerus)
posterior (anterior surface of posterior axillary fold)
Age
The risk of developing breast cancer increases with age
The majority of breast cancer cases occur in women older than
age 50.
www.cancer.gov/bcriscktool
www.cancer.gov/bcrisktool
Race
White women have greater risk of developing breast
cancer than Black women (although Black women
diagnosed with breast cancer are more likely to die of the
disease).
www.cancer.gov/bcrisktool
Routine Mammogram
American Cancer Society
Patients 20-40 years old
Patients>40 every year