Inspection | |
Breast | Assess size, shape, symmetry, skin changes, dilated veins, dimpling, puckering, ulceration, peau d'orange, and nodules |
Nipples |
Assess level, direction (normally, downward, forward and lateral), retraction, discharge Look for the 6 Ds: Destruction, Deviation, Depression (retraction), Discoloration, Discharge, and Dermatitis |
Areola | Color, surface, size |
Palpation | |
Breast |
Palpate the normal side first Palpate the following 7 areas: 4 breast quadrants, subareolar region, axillary tail, and the undersurface of the breast Mass: site, size, shape, tenderness, mobility, surface (smooth vs irregular), consistency (cystic, soft, firm, hard), edge (well vs ill defined), relation to surroundings (skin, muscles) |
Axillary lymph nodes |
Consistency: hard/rubbery, nodular/smooth Size and mobility (fixed/mobile) |