Breast Examination.pptx examination of axillary lymph node

Position patient supine, with the hand on the side you're examining behind their head.
Palpate the asymptomatic breast first.
Palpate using the flat palmar surface of your fingers.
Palpate using a systematic technique to ensure you examine all of the breast regions.

1. CLINICAL BREAST EXAMINATION BY: HIRA ALTAF (202001)

2. Normal Anatomy of Breast The breast is located on the anterior thoracic wall. It extends horizontally from the lateral border of the sternum to the mid-axillary line. Vertically, it spans between the 2nd and 6th costal cartilages. It lies superficially to the pectoralis major and serratus anterior muscles.

3. Quadrants of Breast

4. LYMPHATIC DRAINAGE OF BREAST The lymphatic drainage of the breast is of great clinical importance due to its role in the metastasis of breast cancer cells. There are three groups of lymph nodes that receive lymph from breast tissue – the axillary nodes (75%), parasternal nodes (20%) and posterior intercostal nodes (5%).

5. CLINICIAL BREAST EXAMINATION It inclues : Careful History Taking Visual Inspection Palpation of : _both breasts _armpits and _roots of the neck Educating women on breast self examination and awareness,particularly on breast lumps.

6. PRE REQUISTIES OF BREAST EXAMINATION Wash your hands and done PPE. Introduce yourself to the patient. Explain the procedure and gain consent. Assure privacy by draping parts of the body not being examined Offer chaperone to the patient. Expose the patient Adequately Position the patient correctly.

7. POSITION OF THE PATIENT

8. INSPECTION

9. CHANGES THAT CAN OCCUR IN NIPPLE

10. PALPATION Use finger pads of middle 3 fingers. Palpate the normal breast first. First examine is sitting position and then in supine position with hand of patient behind head. Palpate the breast from outside towards nipple. Use on or two hand to elicit lumps. Press the breast against chest wall. Rolling fingers in small circular motions. Press lightly for superficial layers and firmly for deeper layers.

11. Examine the axillary tail between your finger and thumb. Palpate the nipple by holding it gently between your index finger and thumb. Try to express any discharge and note the colour and consistency and observe the number of ducts affected. Palpate the regional lymph nodes ,including the supraclavicular group,cervical and infraclavicular. Palpate axillary lymph nodes as well.

12. Examination of axillary lymph nodes

13. If you find any mass then assess wether it is fixed underneath. For this ask the patient to place hands on her hips,hold the mass between your thumb and forefinger.Ask her to contract and relax the pectoral muscles alternatively by pushing into her hips.As the pectoral muscle contracts ,note wether the mass moves with it and if it is separate when the muscle is relaxed.Fixation suggests malignancy

14. Breast Lump Breast lump should be assessed for : SIZE SITE SHAPE NUMBER SHAPE EDGE CONSISTENCY MOBILITY\FLUCTUANCE

15. TRIPLE ASSESSMENT OF BREAST History and Examination Diagnostic imaging by mammography or ultrasound scan. Cytology(FNAC) or Histolgy