1. BREAST EXAMINATION
DR. RAMI AYYOUB

3. mammary or milk line

4. FIRST ; Introduce yourself chaperone Ensure privacy LIGHT EXPOSURE
Permission

5. Position Fully undressed to waist
SITTING , AND SUPINE WITH Upper body raised at 45 at the legs
If the lump appear only in certain position ,you should examine pt in that

6. Inspection YOU are on the right of pt. pt sitting : Size Symmetry Scar
Visible discharge

7. 5) Skin :
- pulled or puckering
- peau d’orange ( oedema raised by obstruction of lymph)
-Nodules or ulcer
- Dicoloration
- Tetharing
- Rash , Hypo or hyperpigmentation
- Ulceration

9. 6) Any Lumb : ** 3 positions -site -size -shape -overlying skin

10. 7) Nipple and areola :
Nipple:
- inversion or retraction/ destruction/ displacment or deviation
- discharge
-Skin change
- Duplication
-Are at Same level

12. ** Normal areola are darker than adjacant skin and contain small nodule ( montgomery’s tubercles)

13. 8) Ask pt to elevate her breast to see underweath Ask pt to lay down 9)Axilla : - Ask pt to raise her arms above her hand - look for any skin change or enlargment - Ask pt to press her hans against hip to tense pectoralis muscles > some masses become visible

14. - look for visible LN
- distended vein
- arm lymph edeama
Muscle wasting
10) Supraclavicular fossa :
- Look virchow’s gland.

15. >> Palpation Pt must sitting 45
Normally breast texture varies according to age, parity, body mass, and hormonal activity, from featuless to firm and fibrous with nodule also at the end of the 2nd half of menstrual cycle , breasts enlarge and become tender .

18. Feel breast with flat of finger not with palm of hand. 1. temp. 2
Feel breast with flat of finger not with palm of hand. 1.temp. 2.tenderness 3. Mass site, size, shape, surface, edge, consistance. check nipple for discharge

19. 4.Check for nipple discharge : massage the breast toward the nipple then press 5.Feel axilla you may find normal ectopic breast tissue