Physical Assessment

Physical Assessment: Objective Data

To determine that a patient may be at risk for breast cancer, conducting a physical assessment before any other diagnostics tests is vital. The nurse would be able to collect all the necessary data and findings to formulate a nursing diagnosis to refer to the appropriate health care professionals. As per the physical assessment of the breasts, the nurse will conduct inspection and palpation of the breasts and axillae of the patient to determine if there are any abnormal findings that may pose as manifestations of breast cancer. Note: There is no auscultation step of the physical breast examination.

The nurse will first start inspecting the breasts. The size and shape of the breasts will be examined bilaterally.
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The skin should appear to be of even colour and appear smooth in texture. Abnormal findings should be noted if the nurse notices areas of bulging, redness in skin colour, or dimpling. The should be no signs of edema. The above findings are significant as skin changes can indicate many manifestations related to breast cancer. Uneven skin tones can indicate hyperpigmentation. Bulging, redness, or dimpling can indicate signs of inflammation, following redness and heat. Edema detected in the skin can pose a condition that suggests cancer (p. 428). One of the signs and symptoms of breast cancer is lymphatic obstruction. This condition can cause edema. To detect if edema is present, the “skin around the breasts and the areola will appear to be thickened and the hair follicles will look exaggerated, giving a pig-skin or orange peeled look “(p. 428). Note: If a female is pregnant
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For inspection, the axillae will be examined for any rash for infection. Palpation of the axillae will occur with the following steps (Jarvis, 2009, pp. 417-418):

1. The nurse will lift the patient’s arm and support it on his/her left arm so that the patient’s muscles are relaxed and loose.

2. The nurse will use her right hand to palpate the axilla and will use their fingers to reach high into the axilla. The nurse will be palpating for any tender and enlarged lymph nodes along the axilla.

3. The nurse will then move their fingers firmly down in 4 directions: down the chest wall in a line from the middle of the axilla, along the anterior border of the axilla, along the posterior border, and along the inner aspect of the upper