Breast

Question 1

Steps

Answer 1

1. Explain the procedure to the patient
2. ask which breast is of concern
3. hands on hips and inspect the breast
4. Hands behind the head with elbows back
5. same position lean forward
6. patient supine
   palpate the asymptomatic breast first, spiral motion including axillary tail
7. Ask patient to palpate nipples for discharge
8. hands behind head on other side and repeat.
9. palpate the mass for location, size, consistency and fluctuence (ask patient to flex chest)
10. feel axillary lympho nodes
11. cervical lymph nodes

Question 2

Handover

Answer 2

Evidence of nipple ulceration, erythema in lower right quadrant

nipple retraction and peau d’orange in left lower outer quadrant

frim craggy 3x3cm in the left upper quadrant, 4cm away from the nipple and it seemed to be attached to the underlying tissues

no other lumps on palpation

Question 3

investigations

Answer 3

ultrasound scan

core biopsy