Breast Examination Techniques

• It is importnat for women to learn to examine themselves through inspection and palpation of sexual body parts.
• Many conditions, including life-threatening ones, can be detected through self-examination.
• Early detection of cancer is crucial for controlling and curing it.

Definition of Breast Examination

• A technique involving thorough inspection and palpation of the breast.
• It is conducted postmenstrually, during the antenatal and postnatal periods, and after menopause.
• It is performed to collect data about the breast condition of mothers.

Objectives of Breast Examination

• Detection of abnormalities like mass, swelling, or inflammation.
• Assessment of breast size, shape, contour, elasticity, and symmetry.
• Evaluation of the nipples for type, size, and secretions.
• Examination of the areola and nipple for blisters, cracks, or fissures.
• Assessment of the breast for signs of engorgement, mastitis, or abscess.
• Education of women on how to perform breast self-examination.

Indications for Breast Examination

• At puberty for early detection of breast cancer.
• During the antenatal period for breast appraisal.
• In the postpartum period to detect engorgement or other breast complications in lactating mothers after all milk has been expressed.
• After menopause or following hysterectomy for the early detection of breast cancer.
• For women who may potentially develop breast cancer.
  • This includes those with early menarche, those over 40 years of age, and those with a family history of breast cancer.
  • Also includes nulliparous women whose first parity occurred after age 34, those exposed to carcinogens, and those with other cancers like endometrial, colon, rectum, salivary gland, and ovary cancer.

Equipment for Breast Examination

• A good lamp
• Mirror
• Disposable gloves

Pre-Procedure Steps

• Explain the procedure to the woman, listen, and respond to her concerns.
• Discuss the advantages of regular breast self-examination.
• Ask the client to empty their bladder for comfort.
• Close windows and maintain the client's privacy to undress.

Technique for Examination

• Ask the woman to undress from the waist up and sit on the examining table with her arms at her sides, facing the examiner.
• Inspect the breast for shape, size, and symmetry. Note the nipple position, usually at the level of the fourth intercostal space.
• Inspect the overlying skin for color and venous pattern.
• Look at the nipples, noting size, shape, and direction. Check for rashes, sores, and discharge.
• Repeat inspection in a sitting position with arms raised over the head.
• Examine the clavicular and axillary regions through palpation of the tail of the breast, checking for enlarged lymph nodes, tenderness, discoloration, swelling, or lesions.
• Ask the client to assume the supine position and put her right arm over her head.
• Make an imaginary division of the breast into 4 quarters.
• Palpate the breast tissue starting from the outer edge of the upper quadrant at 12 O'clock wise, using a circular manner toward the nipple in both breasts.
• Use the palms of the hand or the flat pads of the three middle fingers to feel large areas of the breast against the chest wall, rather than the finger tips.
• If a lymph node is found, palpate it, noting its consistency, mobility, and presence of tenderness.
• If a mass is found, palpate for the following characteristics: location in relation to quadrant size, shape, consistency (soft, firm, or hard), tenderness, and mobility.
• Inspect and palpate the areola and nipples. Gently spread the areola and squeeze the nipple between fingers to demonstrate the presence of cracks, fissures, and secretion.
• Record normal and abnormal findings and date of next examination to refer the client to a physician if abnormalities are present.

Breast Self Examination

• Stand in front of a mirror and inspect your breasts for changes in contour, shape, color, and texture of the skin and nipple, as well as any evidence of discharge from the nipples with arms in different positions.
• Move gently and smoothly over every part of each breast using superficial and deep pressure of fingers with verticle strips, concentric circles, and wedge sections.
• To distribute the breast tissue evenly on the chest wall, place a folded towel or a pillow under your mid-back while lying down.
• Look for any unusual discharge, especially pinkish or reddish discoloration, by gently squeezing the nipple (right and left).
• When bathing or showering, examine your breast by raising your left arm over your head.
• Report any abnormal discharge to your doctor immediately.