Clinical Breast Examination Reviewer Check-Off List
COMMUNICATION

Introduce herself

Check on patient comfort and make necessary adjustments

Elicit and respond to questions/concerns
POSITIONS
Visual inspection (frontal and lateral)
 Arms overhead
 At sides
 Hands on hips, pressing down
 Leaning forward
Palpate lymph node areas (sitting position)
 Supraclavicular
 Infraclavicular
 Axillary
Patient supine
 Spreads breast tissue evenly on chest wall

Place ipsilateral arm comfortably at right angle to head
PERIMETER

Clavicle superiority

Lateral edge of sternum medially

Inframammary fold inferiorly

Latissimus dorsi muscle laterally

Along imaginary line connecting mid-axilla to distal end of clavicle
PATTERN OF SEARCH

Follow a strip pattern up and down covering every inch of breast

Leave fingers on skin and include an adequate amount of overlap
PALPATION

Use 3 middle finger pads, not tips

Have hand flat or bowed upward

Use a sliding motion and do not lift fingers

Include nipple/areolar area
PRESSURE

Use 3 levels of pressure: light, medium, deep

Ask about your comfort with the pressure used for the exam

Solicit feedback from patient on pressure
PATIENT EDUCATION

Point out breast tissue perimeter and anatomic landmarks

Reinforce BSE pattern and when to do BSE

Review time for next mammogram, clinical breast exam and breast self
exam

Check for patient understanding and agreement
Adapted from California Department of Health Services Continuing Education Program. CBE: Proficiency ad Risk
Management