breast exam

Clinical breast examination

Okay, Ellen, we're going to go ahead

and do the breast exam now. Ok.

So in order for me to really inspect the tissue

I'm going to have to have you lower your gown to your waist.

Okay.

Alright.

And I'm just looking for general symmetry,

any, um, retractions, things of that nature.

Lesions to the skin.

Go ahead and have you put your hands

above your head

and press your palms together.

Okay.

And now onto your hips,

and just press down on your hips. Good.

And lean forward for me.

And back.

And then shrug your shoulders. Good.

You can bring your gown up if you want.

This helps me see the breast tissue

in different angles

so I can better tell whether you have lesions or lumps,

anything like that.

Okay.

Um, go ahead and lay you down at this point.

Have you put one arm above your head, okay.

And I'm just going to expose one side at a time.

First we start with the Tail of Spence.

Okay.

And moving in concentric circles,

go all the way around the breast tissue,

feeling for any lumps, lesions, fibrotic tissue, tenderness.

Okay.

All the way around until we get to the nipple.

And then we look for any discharge,

and for nipple inversion,

and palpate right underneath the nipple.

Okay.

Alright and you can put that arm down.

Put this one up.

Same on this side.

And this would be a good opportunity for me

to ask you if you do self-breast exams,

and talk about when is the best time to do them

and, uh, the technique...review the technique.

Okay.

Again, looking for nipple discharge,

inversion, and right underneath the nipple.

Good, you can put this arm down.

Okay, let's go ahead and check your axillary lymph nodes.

Just try to relax your arm if you can.

Okay.

I'm going to do three sweeps,

starting in the mid-axillary line,

all the way up in the armpit,

down,

and then the anterior axillary line.

And posterior axillary line.

And then we just follow them in the upper medial aspect

of the arm.

Okay.

Let's try the other side.

Try again to relax your arm.

We'll do a sweep mid-axillary,

anterior,

and posterior.

And along the medial aspect

of your upper arm.

Good, everything appears to be healthy and normal.