Clinical Breast Examination

Patient X is feeling a bit anxious. Today, she is scheduled for a checkup, which involves a breast examination. She has been feeling a little lump at the side of her left breast and is a bit worried about it. Maybe it’s just normal. Or maybe not. There’s only one way to find out, and she’s headed towards it right now. Her heart beats fast as she approaches the room where checkups are conducted. I can do this, she tells herself at the door. She breathes deeply, turns the doorknob and enters the room where her doubts will be answered.

As women, we tend to be more conscious of our body. We go to the gym, watch what we eat, do certain exercises and many more just to improve out appearance. For us, it is best to make a good impression. One of the most important parts of the body that women care most about are the breasts. The bigger they are the better. Some even undergo breast transplants to make them look and feel good. However, have we really taken a break from all the appearance issues and try to give time examining whether ours are still okay or not? Whether they are still normal or if some abnormalities have began to arise?

Clinical Breast Exam: An overview

Clinical breast examination (CBE) is a physical examination of the breasts performed by a physician, nurse or trained midwife. Usually, these exams are inexpensive and are often performed as part of your routine annual checkups. CBE proves to be one essential part of breast cancer screening for all women of different ages.

It can also be helpful when it comes to detecting a breast mass, especially those women who belong at normal risk and under the age of 40 for whom mammography is not recommended. On the other hand, for those women aged 40 years and older, clinical breast exams are complementary to mammography.

This exam requires the patient to undress from the waist up. For women ages 20-40 years old and are at normal risk, CBE must be done at least 1-3 years, while for the women aged above 40 years old and are at normal risk, CBE must be performed yearly.

For those at increased risk, however, may be advised by her physician in charge to have more frequent CBEs and yearly mammograms.

How it is done

CBE consists of two parts: First, visual inspection to identify physical signs of breast cancer. Here, the health professional inspects the breasts of the patient (who is in sitting position, with arms on hips, then arms raised over the head) for abnormalities in size or shape, or changes in the skin of the breasts or nipples. The breast is also checked for dimpling, puckering or bulging of the skin, nipple discharge, among others, which are physical symptoms of breast cancer.

Second, palpation which involves using the finger pads to physically examine all areas of breast tissue including lymph nodes (underarm area) to identify lumps using the three middle fingers doing overlapping circular motions. Not only that, the shape and texture of the breasts, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues are also given special attention. The patient here is asked to lie down with their hands overhead and a pillow is placed under the shoulders or the lower back. By doing so, you can be sure that breast tissue are evenly distributed.

The area under both arms will be examined as well, such as the lymph nodes in the underarm area. This procedure takes about 8 minutes on average.

The patient’s medical history, screening practices, any breast changes that she has noticed, and risk will also be explored and examined. For premenopausal women, CBE is usually conducted 5-10 days after the onset of menses, and avoiding the week before the period is preferable. While for those postmenopausal, CBE may be performed at any time.

 

Some people, because of their busy schedule often overlook the point of having regular checkups. For them, those are just a waste of time and only opt for medical attention when they already feel something wrong. However, what they do not know is that by going to checkups, they may actually save time from future hospitalizations due to complications of undetected health problems. Remember, prevention and early detection are always better than cure.

Sources:

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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