ABSTRACT
Breast examination is an important part of the routine clinical work-up. The patient should be examined unclothed in both the sitting and supine positions. The importance of breast self-examination can be emphasized at this time. Palpation should also include the axilla and supraclavicular areas. The entire breast and chest wall should be examined. The patient should be examined in the sitting position with the patient’s arms raised over her head, hands pressing on the hips, and arms relaxed as the patient leans forward (Figure 3.1). The patient should then be examined on her back with her arms at her side as well as
Figure 3.1 The patient is examined systematically in several positions and the findings recorded. Visualization with arms at sides and extended accentuates the effect of a tumor shortening the Cooper’s ligaments with resulting flattening and concave appearance of the skin
over her head. Clinical breast examination is best performed with circular motions using fingerpads (Figure 3.2). Tactile sensitivity may be improved when the breast is wet or with use of sonar gel.
