· Inspection
o Patient sitting
§ Assess – asymmetry
§ Visible masses
§ Distortion or skin tethering
§ Nipple discharge
§ Ulceration
§ Oedema and erythema of skin (Paeu d’orange)
· Palpation
o Patient lying in near supine position, or in semi recumbent position if the breast are large
§ Arms raised
§ Hand behind the head
o Palpate the four quadrants including the axillary tail.
o If a mass is detected examine it further with the thumb and the forefinger
§ Site
§ Size
§ Surface
§ Shape
§ Mobility
§ Consistency
§ Tenderness
§ Transilluminating or not
§ Enlargement of the lymph nodes
· Examine axillary and cervical draining nodes
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