And remember, these are skills that take time and practice!
You may not get them all done for every scan, but if you always try your best, if you always strive to improve and learn from each scan, each patient and each pathology, then you will have a career of success and confidence.
1. Scan slowly and steadily and with light pressure.
Whatever you do, don't put the weight of your arm all on the hand and wrist. This causes a compression of the breast tissue that can make it harder to see masses, restricts blood flow to tissues when using doppler and can hurt your patient!
Use light pressure to scan steadily across the breast until something catches your eye, then pause, focus in nice and close, adjust your settings to optimize that area more clearly, determine if this is a real thing or just shadowing from tissue interfaces and if so then proceed to document, measure and assess with color doppler.
2. Always scan the entire axilla.
The easiest way to find lymph nodes in the axilla is to align to the major blood vessels in the arm pit (they run obliquely from superior to inferior), adjust your depth and settings until you can see them clearly, then slowly scan with your attention focused just anterior to the vessels and you will see some lymph nodes there.
Practice this on every patient to train your eye. The more you do it the easier the lymph nodes are to find.
3. Remember that your patients are just normal people.
Breast cancer is a huge scary thing that many women lose a lot of sleep over.
I like to take a minute to explain to my patients what they may feel in their breast during their manual self-exam. Specifically what cysts, benign masses or normal fibrous tissue feels like compared to a concerning mass.
Many women have no idea that the things they feel in their breast can actually be normal, benign and no cause to worry. I find the most helpful tool to provide women with is a better understanding of their own bodies.
This is an easy way to explain things:
BENIGN usually feels: Soft, Mobile and Painful.
CANCER usually feels: Firm, Fixed in place and Painless.
Having my mother go through breast cancer makes it very easy for me to imagine that this woman on my scanning table is someone’s mother, sister or daughter. I want the best for my family, and I know that their family wants the best for them. So that is what I always try to offer. Just simple kindness and consideration.
Remember: As you practice these tips while scanning, always begin with confidence in your abilities. Trust in yourself. You can do this and you can do it well.