The document outlines the steps for performing a physical examination of the breasts. The examination involves inspection of each breast followed by palpation of each breast one at a time using both hands in a wedge pattern with light and deep pressures to cover all areas. The nipples are pressed to check for any discharge and the underarms are palpated to check for enlarged lymph nodes. If a dominant breast mass is found, its characteristics are determined to aid in clinical diagnosis.

1. How to Do Physical
Examination of the Breasts
Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg
August 6, 2016

2. How to Do Physical
Examination of the Breasts
Inspection
Palpation

3. How to Do Physical
Examination of the Breasts
Inspection
Inspect both breasts for anything unusual –
size, contour, skin changes, etc.

4. How to Do Physical
Examination of the Breasts
Palpation

5. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breasts with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breasts.
Look for a dominant mass.
Then, press the nipples for any discharge. Then palpate the armpits for any
lymph node with the arm lowered from the head part to lax the axilla folds.

6. How to Do Physical
Examination of the Breasts
RIGHT BREAST

7. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

8. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

9. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

10. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

11. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

12. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

13. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

14. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

15. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

16. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

17. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

18. How to Do Physical Examination of the Breasts
Then, press the nipple for any discharge.

19. How to Do Physical Examination of the Breasts
Then, palpate the armpit for any lymph node with the arm lowered from the
head part to lax the axilla fold.

20. How to Do Physical
Examination of the Breasts
LEFT BREAST

21. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

22. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

23. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

24. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

25. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

26. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breast with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breast.

27. How to Do Physical Examination of the Breasts
Then, press the nipple for any discharge.

28. How to Do Physical Examination of the Breasts
Then, palpate the armpit for any lymph node with the arm lowered from the
head part to lax the axilla fold.

29. How to Do Physical Examination of the Breasts
With the patient lying down, with arm raised over the head part, palpate
the breasts with two hands, one breast at a time, using the flats of fingers,
wedge pattern, with at least 3 sweeps per wedge, with light to deep
pressures and making sure to cover all areas and quadrants of the breasts.
Look for a dominant mass.
Then, press the nipples for any discharge. Then palpate the armpits for any
lymph node with the arm lowered from the head part to lax the axilla folds.

30. How to Do Physical Examination of the Breasts
If a dominant breast mass is palpated, proceed to determine the following:
location; size; consistency; nature (solid or cystic); border; mobility;
tenderness; erythema; etc.
Use the characteristics of the mass and other relevant findings such as
axillary lymph node to decide on the clinical diagnosis.

31. How to Do Physical
Examination of the Breasts
Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg
August 6, 2016