hi I'm Simon one of the junior doctors can I just check your name and age please yeah it's Leola and I'm 23 nice to meet Leola so today I need to perform a breast examination have you ever had one of these before no okay and which breast is have concern to you um I felt a lump in my left breast okay so what this examination will involve is me having a look and a feel of the breast tissue are you happy for me to go ahead yeah that's fine all right what I'll do is I'll
let you get undressed so taking your top things off including your bra and then popping this gown on to cover up in the meantime I'll fetch one of the nursing staff to act as a chaperone throughout okay all right okay Leola if you could just put your hands on your hips for me and now just press down on the hips and now if you could put your hands behind your head and push your elbows back and now just lean forward for me okay thank you okay Leola if you could lie down for me now I'm
going to examine the breath and if you could just put your right hand behind your head for me thank you I just want to make sure that there's no discharge from the nipple if you could just squeeze your right nipple between your thumb and index finger okay thank you if you could just switch the hand behind your head thank you now could you just tense your chest muscles Le over thank you what I need to do now is have a feel of the the glands in your armpit okay so if I could start on the
right I'll just take all the weight of your arm so just completely relax it okay okay Leola I'll do the same on your left side now so again just relax let me take all the weight I'm just going to have a feel of the glands in your neck now all right that completes the examination thank you very much Leola I'll just leave you to get dressed now thanks today I performed a breast examination on Leola a 23-year-old lady on inspection of the right breast there was evidence of nipple ulceration and there was athema in the
lower outer right quadrant on inspection of the left breast there is evidence of nipple retraction and also podor range in the left lower outer quadrant on palpation of the left breast there was a firm craggy 3x3 CM mass at approximately 2:00 it was located 4 cm from the nipple and it appeared to be Tethered to the underlying tissues there were no other lumps on paration and there was no lymph node involvement for completion I'd consider further examinations to detect the presence of disseminated malignancy I would arrange ultrasound scan and also core biopsy or fining aspiration
of the mass
