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Williams Gynecology
| Section 1 Benign General Gynecology > |
Medical History and Physical Examination
Sections: Breast Examination, Breast Inspection, Lymph Node Evaluation, Breast Palpation, Pelvic Examination, Inguinal Lymph Nodes and Perineal Inspection, Speculum Examination, Bimanual Examination, Rectovaginal Examination.
Topics Discussed: bimanual examination; examination of breast; lymph nodes, inguinal; manual pelvic examination; rectovaginal examination.
Excerpt:"For many women, gynecologists often serve as both specialist and primary care provider, and as such, are given an opportunity to prevent and treat a wide variety of diseases. The incidence of these may vary greatly depending on the age group treated. Thus, the focus of medical questioning should reflect these changing risks.Although mammography has been shown to effectively detect breast cancers, clinical breast examination (CBE) may identify a small portion of these malignancies not detected with mammography. Additionally, CBE may identify cancer in young women, who are not typical candidates for mammography (McDonald, 2004). Clinical breast examination can be completed with various methods. However, in an attempt to standardize performance, a committee for the American Cancer Society has described a CBE that combines visual inspection with axillary and breast palpation (Saslow, 2004).Initially, the breasts should be viewed as a woman sits on the table's edge with her hands pushing against her hips to flex the pectoralis muscles. Alone, this position enhances asymmetry, and additional arm positions, such as placing arms above the head, are not required to add vital information. Breast skin is inspected for erythema; retraction; scaling, especially..."
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