1.

Introduce yourself and verify the client’s

identity.
2.Explain to the client what you are going to
do, why it is necessary, and how the client
can cooperate.
3.Perform hand hygiene and observe other
appropriate infection control procedures.
4. Assemble equipment and determine the need
for examination of the breasts.
5. Provide for client privacy.
6. Ask the patient’s medical history (e.g.
menstrual cycle, medications like
contraceptive pills, family history, past
surgical procedures)
7. Ask the patient to disrobe to the waist and
to be seated with hands in the lap.
8. Examine the breasts:
o Observe nipples for color, discharge,
and retraction or dimpling
o Observe breasts for size, shape or
contour, symmetry, skin color,
vascularity, and skin retraction. Ask
patient to press hands against hips to
bring out dimpling or retraction.
o Have patient raise hands above head
and observe for irregularities in skin
texture and dimpling.
o Have patient lie down.
o Place a small pillow under patient’s
shoulder on side you are examining
 and have patient raise the arm
overhead.
o Lying down spreads the breast tissue
evenly over the chest wall.
o Use the three middle finger pads of
your hand to feel for any breast
lumps, using overlapping small circular
motions to feel the breast tissues.
o Use light pressure to feel the tissue
closest to the skin; medium pressure
to feel deeper; and firm pressure to
feel the tissue close to the chest and
ribs. Use each pressure level to feel
breast tissue (before moving on to
the next area).
o Move in an up-and-down pattern,
starting at straight down side from
the underarm (tale of spence) then
move across the breast to the middle
of the chest bone (sternum-
breastbone).
o Check the entire breast area, going to
ribs and up to neck or collar bone
(clavicle).
o Repeat all the procedures on the
other breast.
9.Perform hand hygiene.
10. Document the assessment and report any
findings.