If you start out with a thorough plan of attack you will be able to better handle the assessment and documentation of anything that you find, and be confident that nothing was missed.
My 3 must-do methods for breast scanning:
1. Scan Breast tissue in vertical layers
I always begin with the deepest layer, adjusting all my settings to bring that area into sharpest focus, then assess in two planes. I then re-adjust my settings to bring the middle plane into focus and assess, and then finally adjust for the top, most superficial layer and assess.
Continually adjusting the settings to focus in on the area you are assessing is half the work in scanning and makes the rest of your job so much simpler.
My confidence increased dramatically when I started to use this method, I felt much more certain that all parts of the breast had been examined closely and nothing missed.
2. Scan each breast clockwise in quadrants
The simplest I have found so far is to scan one quadrant at a time in a clockwise rotation, beginning at 12 o’clock.
Whichever plan you make, be sure to stick to it! No matter what is found, or not found, only by adhering to the plan can you be confident that you thoroughly assessed all of the breast tissue.
2. Assess the nipple and retro areolar tissue separately
Secondly, zoom in on any ducts you see just under the areolar surface to assess for DCIS which can appear as masses with CF within the ducts, ducts that do not taper or enlarged ducts (My clinic uses > 3mm AP as abnormal).
It can be normal to see dilated ducts in women who have breast fed, but since DCIS accounts for the majority of invasive breast cancers it is very important to assess this area for your own assurance of a thorough exam.
Tip: Use the pinkie finger of your scanning hand to to gently roll the nipple over the finger to scan along its length. This is one of the best ways to eliminate shadowing from the compressed nipple and clearly see the ducts.
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.