Reference Manual - IARC Screening Group

Performing Breast and Pelvic ExaminationsPalpation• Have the woman lie down on the examining table.Placing a pillow under her shoulder on the side being examined willspread the breast tissue and may help in examining the breast.Place a clean sheet or drape over the breast you are not examining.• Place the woman’s left arm over her head. Look at the left breast tosee if it looks similar to the right breast and whether there ispuckering or dimpling.• Using the pads of your three middle fingers (Figure G-4a), palpatethe breast using the spiral technique. Start at the top outermost edgeof the breast (Figure G-4b). Press the breast tissue firmly against theribcage as you complete each spiral and gradually move your fingerstoward the areola. Continue this until you have examined every partof the breast. Note any lumps or tenderness.Wetting your fingertips with dilute soap solution or betadine may helpyou identify small lumps or axillary nodes.Figure G-4a and b. Spiral Technique of Breast Examination• Using the thumb and index finger, gently squeeze the nipple of thebreast (Figure G-5). Note any discharge: clear, cloudy or bloody.Any cloudy or bloody discharge expressed from the nipple should benoted in the woman’s record. Although it is normal to have somecloudy discharge from either or both breasts up to a year after givingbirth or stopping breastfeeding, rarely it may be due to cancer,infection or a benign tumor or cyst.G-6 Cervical Cancer Prevention Guidelines for Low-Resource Settings