Method Of Exam
Author: A. Chandrasekhar, MD
Consultant: F. Folk, MD
ask the patient to lie flat and stand at the patient's right side,
place a small pillow under the shoulder
with ipsilateral arm above head
spreads the breast more evenly across chest
warm your hands and keep conversing with patient to make them comfortable
palpate breasts with both the flat of your hand and fingers.
with flat fingers compress breast tissue
follow systematically, in a circular pattern around the nipple or along the radial lines (simulate a clock) or vertical segments and feel the entire breast, including the tail near the axilla.
consistency of tissue
fat (soft) and gland (lumpy)
firm transverse ridge along lower edge
note any tenderness
feel the areola and nipple.
compress the areola, going about its circumference. Gently squeeze the nipple to note for discharge.
palpate nipple for elasticity
Characteristics of mass if any / Dominant mass
move mass and watch for dimpling
compress the areola with index finger in radial positions around nipple
note color, consistency and quantity of discharge
Breast has firm elasticity in young. Glandular tissue may feel lobulated, granular, irregular ("tapioca").
Slight tenderness and fullness can be anticipated in premenstrual period.
In older women, breasts feel stringy