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GTA Objectives ~ Visual Exam~
Lymph Node Palpation ~
Breast Exam
Project Prepare gynecological teaching associates (GTAs) teach medical students and other health care providers how to do the clinical breast exam (CBE).
Project Prepare GTAs have the following objectives in teaching the CBE:
- Teach students to do a thorough, proficient, and sensitive CBE in 5 to 8 minutes, using the latest techniques recommended by the American Cancer Society
- Teach students to create trust and lessen patients' fears by sensitively discussing feelings and anxiety related to the breast exam, breast health and disease
- Give students the tools with which to teach their patients how to do the breast self exam (BSE) and inspire students to empower and encourage their female patients to be partners in their own health care
- Teach students to maintain a relaxed palpation style (relaxed in the knees and in the examining shoulder, arm, wrist, hand, and fingers) for patient comfort and best ability to feel slight tissue changes
- Teach how to describe lumps found in breast tissue so they can be found by other health care providers
- Use a silicone breast model as a learning tool to find and describe the location and characteristics of breast lump
Female Breast Exam Outline
Visual Exam
Perform the visual inspection by observing the breasts in four positions (and demonstrate three views for each position: frontal, lateral, and lateral):
- Arms at side
- Arms above head
- Pectoral contraction
- Bending forward
Describe normal and abnormal visual findings in the visual breast exam.
- Palpate the supraclavicular and infraclavicular nodes
- Palpate the axillary nodes
Breast Exam
Describe the perimeter of the breast tissue and the vertical strip technique.
Select the appropriate position in which to lie down on the table for the small-, medium-, and large-breasted patient in order to evenly distribute breast tissue.
Palpate and identify in the breast:
- Adipose tissue
- Glandular tissue
- Ductile tissue
- Inframammary ridge (if present)
Using one hand, palpate with the pads (not the tips) of the first three fingers:
- Use three levels of pressure
- Make dime-sized circles
- Follow a vertical strip pattern
- Use the appropriate technique to move along the vertical strips (so as to not miss any tissue)
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