Breast Examination

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• Patient sitting upright

Inspect

• hands resting on thighs
• hands pressed into hips
• arms above head
• leaning forward

• Look for
  • assymetry
  • local swelling
  • puckering
  • skin/nipple changes

Palpation

• Patient lies with hand above head
• check for tenderness
• Hand flat to skin
• Palpate each quadrant and along axillary tail
• lymph nodes
  • Axillary
    • medial
    • anterior
    • lateral
    • posterior
    • apical
  • cervical 
  • supraclavicular 

Further

• liver
• percuss back for tenderness
• percuss lung bases for dullness

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