Palpation of the mammary gland – examination method
A thorough examination of the mammary glands is still an extremely important component of the early diagnosis of their diseases. Although the methodology and importance of breast examinations are reported in virtually every medical school, the current tendency to over-specialize may result in a loss of skills or, even worse, doctors will not conduct a thorough examination of the mammary glands during the examination of their patients. If the mammary gland examination is excluded from the standard examination scheme and patients will not be referred for mammography, the possibility of early diagnosis of the disease will be lost. It can be said that this is tantamount to conducting a gynecological examination without taking Pap smears or analyzing feces without detecting hidden blood. In diseases whose early detection is so closely related to improved survival, the importance of these relatively simple methods cannot be overestimated.
Examination of the breast of the patient in an upright position
The beginning of the physical examination of the patient should be carried out in a sitting position. In the upright position, the presence of asymmetry, knots under the skin, skin or nipple contraction, and ulceration of the nipples are more noticeable. In the position with arms raised visible changes in the skin of the lower half of the mammary glands and folds under them. The contraction of the pectoralis major muscle, which occurs when the patient presses her hands on her thighs, can show skin retraction, imperceptible under other conditions.
Palpation of the mammary glands in the standing position allows you to identify the initial changes that would be more difficult to detect when viewed in the supine position. This is especially characteristic of formations located in the upper parts of the mammary gland or in the region of the axillary process, which are more noticeable when the surrounding tissues move down when the patient is in a sitting position. Examination of the supraclavicular areas and both sides of the neck in order to detect lymphadenopathy is also best carried out in the upright position of the patient.