Today we learnt to perform breast examination on a real person. It's the first sensitive test I have ever done throughout the medical career, and it turned out to be great!
The day was divided into a few sessions, and there were demonstration from the so-called "clinical teaching associates", experience sharing from breast cancer patients / survivors, history taking ("interview") of someone who presents with a breast lump, and last but not least, hands-on practice on the associate.
As a guy I was supposed to be terribly nervous, shaking and petrified for the day, but I turned out to be okay with the whole thing. The day started with the demonstration where 12 of us stood around a "doctor" and a "patient" who demonstrated the real technique of clinical breast examination. Well, the feeling of seeing real breasts were... Eerm, surreal. But nah, it wasn't "stimulatory" at all if you wonder. :D When you are concerned about the steps and the patient's problem, you kind of put behind the stray thoughts.
So, yeah, we had experience sharing from a breast cancer survivor next. The talk was engaging since it comes from someone who has been through it all. She talked about her diagnosis, her past, and her concerns throughout the disease. Although she removed her breast and has been well for the past five years, the prospect of a recurrence will be looming for the rest of her life. She said she's already made the preparation should things go down that path, and her children even know where to spread her ashes for the funeral. It's a heart-rending story although she managed to put up a positive front throughout the session. You really get to empathize strongly about "count everyday as a blessing".
Next session was a boring, usual interview session. I played a role of a 53-year old patient who's complaining about a lump in my right breast. It's firm, about the size of a marble, and tends to move about when I touch it. What's worse was my mum and my sister both had a breast lump although those were not cancerous. Haha yeah, you get to role-play these kind of things a lot here.
The last session was the real breast examination. Three of us were allocated to a patient, and we took turn examining the breast. It's kind of interesting how all the protocols work: we have to be extremely careful about our language, for example we should say "examine your breast" instead of "feel your breast". Besides, the very important thing was to get a consent from the patient to perform the examination. After some briefing, three of us shyly took our turns at examining the breast. If you would like to know what the examination involves, there are:
- General observation - the raise your arm, lower your arm, roll your shoulder thingy.
- Palpation - the doctor uses his fingers to examine all areas of the breasts.
- Lymph node inspection - the doctor feels for the nodes below the armpit and along the collar bone.
p/s: And a public health message - if you are a woman, please self-examine your breasts regularly. This is especially important if you have a family history of breast cancer. Ask your doctor about regular breast cancer screening - it really, really saves lives.