A breast exam by a health professional (such as your doctor, nurse, nurse practitioner, or physician assistant) is an important part of routine physical checkups. You should have a clinical breast exam every one to three
years starting at age 20 and every year starting at age 40. A clinical breast exam may be recommended more frequently if you have a strong family history of breast cancer. Breast exams are best performed soon after your menstrual period ends, because your breasts will not be as tender and
swollen as during your period. This makes it easier to detect any unusual changes. If you have stopped menstruating, schedule the yearly exam on a day that's easy for you to remember, such as your birthday. Before your breast exam, your health care provider will ask you detailed questions about your health history, including your menstrual and pregnancy history. Questions might include what age you
started menstruating, if you have children, and how old you were when your first child was born. A thorough breast exam will be performed. For the exam, you undress from the waist up. Your health care provider will look at your breasts for changes in size, shape, or symmetry. Your provider may ask you to lift your arms over your head, put your hands
on your hips or lean forward. They will examine your breasts for any skin changes including rashes, dimpling, or redness. This is a good time to learn how to do a breast self-exam if you don't already know how. As you lay on your
back with your arms behind your head, your health care provider will examine your breasts with the pads of the fingers to detect lumps or other changes. The area under both arms will also be examined. Your health care provider will gently press around your nipple to check for any discharge. If there is discharge, a sample may be collected for examination under a
microscope. Clinical exams and breast self-awareness are important methods of early breast cancer detection and should be performed along with mammography. All three of these methods provide complete breast cancer screening. Breast examination is necessary for evaluation of the 8% to 17% of cancers missed by mammograms, but it is being done less often and less effectively. To improve the use of breast examination, we tested whether a technique to focus attention could improve the call rate (the percent of examinations leading to further evaluation), a measure of
quality, without retraining in examination technique. Clinicians were randomized to complete 1 of 2 dedicated, de-identified forms after routine breast examination: a long form intended to focus attention by requesting general breast descriptors along with clinical information and breast examination findings (10 clinicians recorded 964 examinations) or a short form recording only clinical information and examination findings (11 clinicians recorded 558 examinations). There
was no technique retraining. Study call rates were compared with historical controls (298 breast examinations by 16 clinicians). The call rates by the study groups of clinicians were similar, but the call rate using either form (8.3%) was significantly higher than the call rate in the preceding year when no dedicated form was used (4.7%; P=.031), suggesting a Hawthorne effect in which altering conditions of data collection (using the
dedicated forms) functioned as an independent variable. Surveillance, Epidemiology, and End Results data predicted 3.4 cancers in all 1822 patients; 4 cancers were found. Breast examination call rate doubled when attention was focused on examination results using a dedicated form, and we found the anticipated cancers. Breast examination quality can be improved by focusing clinician attention without retraining in technique. To read this article in full you will need to make a payment References
Article InfoFootnotesFunding: Various donor funds held in the California Pacific Medical Center Foundation, San Francisco, California. No donations were from commercial entities. Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript. Authorship: All authors had access to the data and played a role in writing this manuscript. IdentificationDOI: https://doi.org/10.1016/j.amjmed.2009.08.023 Copyright© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved. ScienceDirectAccess this article on ScienceDirectRelated ArticlesWhich assessment finding in a patient may indicate breast cancer?Change in breast size or shape. Skin dimpling or skin changes (eg, thickening, swelling, or redness) Recent nipple inversion or skin change or other nipple abnormalities (eg, ulceration, retraction, or spontaneous bloody discharge) Nipple discharge, particularly if bloodstained.
What are the abnormal findings of the breast during assessment?Other abnormal findings
Swelling, warmth, redness or darkening of the breast. Change in the size or shape of the breast. Dimpling or puckering of the skin. Itchy, scaly sore or rash on the nipple.
Which finding is considered abnormal while performing a breast examination quizlet?Abnormal findings include areolae that are unequal bilaterally, have an irregular shape, or have lesions or changes in color. Normal: inspect the nipples for position, symmetry, surface characteristics, lesions, bleeding, and discharge.
What is the main purpose of breast assessment?The goal of the breast examination is to determine if the breasts are normal or abnormal. If abnormal, any or all of the following may be indicated: surgical consultation, reexamination at a different time of the menstrual cycle, mammograms, and possibly ultrasound.
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Which assessment finding during a breast examination prompts the nurse to contact
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