Breast Inspections

Patient Assessment for Breast Health

Post-Mastectomy and Reconstruction

• Palpate incisional lines for any irregularities or complications.

• Check for lymphedema in clients with impaired lymphatic drainage on the affected side.

Self-Awareness and Monthly Self-Exams

• Instruct clients to be self-aware of breast tissue to detect changes.

• Encourage monthly breast self-examinations:

  • Perform in front of a mirror.

  • Palpate during a shower.

• Pregnant or postmenopausal clients should choose the same day each month for self-exams.

Optimal Timing for Self-Exams

• The best time for a self-exam is 4 to 7 days after menstruation begins or immediately after menstruation ends.

Examination Process

Techniques and Equipment

• Perform breast exams on all clients using inspection and palpation techniques.

• Equipment required:

  • Gloves

  • Drape

  • Small pillow or folded towel

Documentation of Findings

• Document any nodules:

  • Location: Use quadrant or clock method.

  • Size: Measured in centimeters.

  • Shape: Identify if soft, firm, or hard.

  • Discreteness: Well-defined borders of masses.

• Note additional findings:

  • Tenderness, arrhythmia, dimpling, or retraction over the mass.

  • Lymphadenopathy and mobility of masses.

Client Questions

• Do you perform breast self-examinations? How often?

• Have you noticed any tenderness or lumps?

• For menstruating clients, is there a change with your menstrual cycle?

• Do you have thickening, pain, drainage, distortion, or changes in breast size?

• Have you ever had a mammogram? If so, how frequently?

• Has anyone in your family had breast cancer?

• Are you aware of the risks for breast cancer?

• Are you taking medications that might affect your breast tissue?

Inspection Guidelines

Client Positioning

• For women:

  • Sitting or Standing:

    • Arms at the side.

    • Arms above the head.

    • Hands on hips, pressing firmly.

    • Leaning forward with arms out in front or on hips.

• For men:

  • Sitting or Lying Position:

    • Arms at the side only.

Visual Inspection Parameters

• Check for:

  • Size and Symmetry: One breast may be slightly larger.

  • Shape: Convex, conical, or pendulous.

  • Venous Patterns: Symmetric venous patterns and consistent skin tone.

  • Skin Condition: No lesions, edema, or arrhythmia.

  • Areola: Round or oval shape, darkened pigmentation, color ranging from pink to brown.

  • Direction of Nipples: Typically everted; recent inversion is unexpected.

  • Nipple Health: Check for bleeding or discharge, excoriation under the breast.