Breast examination

OBSERVATION SITTING:

1. Asymetry
2. Scars
3. Nipple retraction
4. Skin tethering
5. Dimpling/peau d’orange
6. Radiation ‘dots’/change
7. ‘Arms up’
8. ‘Arms press into hips’-tensen Pec major
9. Axilla
10. Lymphoedema changes a. Offer measure arm circumference

PALPATION LYING (45DGRS):

1. Palpate 5 quadrants
2. Lump- size, fixation/tethering, tenderness
3. Axilla LN
4. Supraclavicular LN
5. Arm Lymphodema

EXTRA:

1. Abdo + chest + Axial skeleton- for METS
2. Post ALND a. Intercostobrachail sensation armpit b. ‘winging scapula’ long thoracic n.