Breast examination is performed with the patient naked from the waist up. It is also important to remove the headscarf or scarf and leave the neck open. In this way, it is possible to detect lymph nodes in the neck or, as I have noticed in many of my patients, goiter.
The patient is first seated upright so that he can be seen from the front. It is evaluated visually for asymmetry, changes in the skin, differences in the nipple and significant bumps. Then the arms are lifted to both sides and up, then placed on the waist and pressed inwards. In this way, the muscle group that attaches the breast to the chest wall is moved. The aim is to stretch the Cooper ligaments that fix the breast to the chest wall and to evaluate the shortening caused by a possible tumor by looking at the collapse of the skin.
Then, in a sitting position, the doctor examines the neck, around the collarbone and the armpit with the fingertips. In this way, it tries to detect possible lymph nodes and masses. Then, the patient lies on her back and both breasts are evaluated manually. Placing a small pillow or towel under the breast to be examined ensures that the nipple is centered and the breast tissue spreads evenly. Without a pillow, the breast inevitably sags/opens to the side due to gravity and it becomes difficult to evaluate it homogeneously. Although each doctor has his or her own method (circular movements, horizontal movements or vertical movements), the main purpose is to evaluate the entire breast, including the nipple, with the fingertips without pressing too much. This examination is performed in the other breast. Any abnormal findings are recorded.
The woman's self-examination should be the same. An important point to pay attention to is not to squeeze the breast too much and not to press too much. If these are done, it may be perceived as compressed fibrocystic changes or as a mass in the lower rib, especially in low-volume breasts.
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