Inspection Give a brief overview of examination to patient. Ask the patient to remove gown to her waist, assist only if needed. Have the patient relax arms to her side. Have the patient replace the gown. Reassure the patient, if the exam is normal so far, say so.
Palpation Have the patient lie supine on the exam table.
Ask the patient to remove the gown from one breast and place her hand behind her head on that side. Begin to palpate at junction of clavicle and sternum using the pads of the index, middle, and ring fingers. If open sores or discharge are visible, wear gloves. Press breast tissue against the chest wall in small circular motions. Use very light pressure to assess superficial layer, moderate pressure for middle layer and firm pressure for deep layers.