BREASTEXAMINATIONCHECKLIST

20132014

Needto
Practice
A.Lymphnodeexam.(Patientseatedwithgowninplace.)
Useindexandmiddlefingers.Pressfirmlyandmovetheskin
overtheunderlyingtissueinarotarymotion.Noteany
tendernessorenlargement.
1. Palpatethecervicallymphnodesbilaterally
2. Palpateaxillarynodes:Placepatientsipsilateralarmon
yourshoulder.Withfingersofoppositehand,reachas
highaspossibletowardstheapexoftheaxilla.Bring
yourhanddowntheaxillapalpatinganteriorlyalongthe
edgeofthepectoralis,andposteriorlyalongthe
latissimus(formingatriangle,withtheapexatthetop).
Oneortwosoft,small(<1cm)nodesmaybefelt,
especiallyinthinpatients.
Repeatfortheotheraxilla.
3. Steparoundbehindpatientandpalpatefor
supraclavicularnodes.

B.Inspection(withpatientsitting).Askpatienttodisrobe.
4. Inspectbreastsfromfrontandsides.Notesize,
symmetry,shape,contour,skin,orscars
5. Inspectbreastsafteraskingpatienttoraisebotharms
overhead.
6. Inspectbreastsafteraskingpatienttoplaceboth
handsonwaistandpresselbowsforward

Feel
Comfortable

BREASTEXAMINATIONCHECKLIST
20132014

Needto
Practice
7. Inspectbreastsafteraskingpatienttoleanforwardwith
armsextendedinfront.
C. Palpation(usingproperdrapingtechnique,patientinsitting
position).
8.Bimanualpalpation:Placeonehandabove,andone
handbelowthepatientsrightbreast.Gentlycompress
thebreasttissuebetweenthepadsofyourfingertips.
Noteconsistency,nodules,masses,ortenderness.
Repeatforleftbreast.

9.Askpatienttoliebackonexamtable.(Pulloutfootrest.)
Askpatienttoplacerightarmbehindhead.Standon
patientsright.

10.Palpatingrightbreast:Uncovertherightbreast.Using
palmarsurfaceoffirstthreefingers(andarotary
motion)compressthebreasttissuegentlyagainstthe
chestwall.Examinethebreastinaradialpatternora
spiralpattern.Notetissueconsistencyandelasticity,
induration,tenderness,nodules,ormasses.

11.Palpateaxillarytail.

12.Palpaterightnipple.Noteelasticity,discharge,
retraction,flattening,inversion,areolar,edema.
13. Gentlyexpressnippleusingthumbandforefinger.Note
anydischarge.(thisisnotpartofaroutinebreastexam,
butisusedtoassesspatientswithbreastdischarge).
14. Repeatexaminationonleftbreast(maybeonrightorleft

Feel
Comfortable

BREASTEXAMINATIONCHECKLIST
20132014
sideofexamtable)

Needto
Practice
MALEBREASTEXAM
15.Examinerstandsfacingpatient.(Patientseatedonexam
table.)

Inspection
16.Visuallyinspectbothbreasts,nipplesandareolae.Note
swelling,ulceration,discharge.

Palpation
17.Palpatetheareolaeandbreasttissueoftherightandleft
breast.Notenodules.
18.Lymphnodeexamination.
Seefemalebreastexam1thru3.

Feel
Comfortable