Inspection begins with the woman sitting on the examination table with both breasts exposed. The patient’s breasts are inspected with her arms at her sides, then with arms overhead, and then with hands pressing on hips to contract the pectoralis major muscles. If the woman has pendulous breasts, the examiner should ask her to lean forward to allow the breasts to hang away from her chest wall so that skin changes or other abnormalities may be seen.

With the patient in each position the examiner assesses breast size, shape, and symmetry. Some asymmetry in breast size is common and is usually normal, but changes in contour such as masses, dimpling, retraction, or flattening should be further evaluated. Contracting the pectoralis major muscles may make subtle skin retraction or other contour changes more evident. The skin color and texture of the breasts are examined for edema, rash, ulceration, or redness. The appearance of the nipple and areola should also be noted.