What's On News October 2022 Clinical breast examination - a guide for general practitioners

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Clinical breast examination - a guide for general practitioners

Tuesday 4 October 2022

October is Breast Cancer Awareness Month - a chance to highlight the importance of patients undergoing clinical breast examiniations when they present to their GP with a lump. 

All patients who present with a lump should undergo a clincal breast examination prior to referral.

Inspection should take place in good light and with the patient seated or standing:

• with arms by the side
• with arms raised above head
• pressing on hips and leaning forward (contracting pectoral muscles).

Pay particular attention to:

• breast contours — skin changes such as erythema, dimpling or puckering, peau d’orange, visible lumps
• nipples — height, inversion, erythema, eczema, nodules, ulcers.

Palpation with the flat of the fingers:
- patient seated or standing:

• palpate supraclavicular and axillary fossae
• palpate breasts, particularly upper quadrants and bimanual examination.

- patient lying flat or at 45 degrees with ipsilateral arm behind her head:

• palpate all quadrants and axillary tail, and around and behind nipple
• the non-examining hand may be used to immobilise a large breast
• a pillow positioned under the shoulder may assist in examining the outer quadrants of a large breast.

The ability to identify breast cancers by palpation may be reduced by the characteristics of the tumour, the surrounding breast tissue and the position of the lesion in the breast.

Details of any breast changes — including size, shape, consistency, mobility, tenderness, fixation and exact position — should be recorded in the patient notes.

This information was extracted from the Australian Government's Investigation of a new breast symptom: a guide for general practitioners.