How to do a clinical breast exam
Other platforms explain it with text and video. In VMS you practice it on the patient.
A clinical breast exam is sensitive: offer a chaperone, explain each step and keep the patient covered except for the area you examine.
Step by step
Prepare
Clean your hands, introduce yourself, offer a chaperone, explain, get consent and keep a drape. [1]
Look sitting
Arms at the sides, hands pressed on the hips, then arms raised: symmetry, dimpling, skin changes, nipple pulling in or discharge. [2]
Position lying
Patient lies back with the arm on the side being examined raised behind the head. [2]
Palpate
Pads of three fingers, small circles with light, medium and deep pressure, in vertical strips from the collarbone to below the breast and from the breastbone to the armpit. [2]
Nipple and areola
Gently feel under the areola. Ask the patient to report any discharge. [2]
Lymph nodes
Armpit, above and below the collarbone. [2]
Describe any lump
Position (clock face and distance from the nipple), size, shape, texture, mobility and tenderness. [2]
Close
Cover the patient, explain the findings and the next steps. [1]
Common errors
- Not offering a chaperone.
- Missing the tail of the breast toward the armpit.
- Only one level of pressure.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
Facts and steps follow NCCPA PANCE Content Blueprint; AAMC Core Entrustable Professional Activities (Core EPAs). VMS is not affiliated with these organizations. Updated: 2026-10-11.