Palpate Axillary Lymph Nodes

Doing your monthly breast self-exam is a great, proactive routine to get into. Feeling for the lymph nodes in your armpits, your axillary lymph nodes, is an important part of the exam. Swollen lymph nodes don’t always indicate a problem, but it’s a good idea to get them checked by a doctor just to be safe. During your monthly self-exam, palpate (or feel for) your axillary lymph nodes by getting comfortable, using the right hand positioning, and feeling the four main parts of your armpit.

Steps

Performing the Exam

1. Relax into a comfortable position. Drop your shoulder into a relaxed position. Take a deep breath to help your body relax. Place your forearm on a table or the arm of a chair so that your arm and elbow are supported.
   • You can also lie down on your back.
   • If you’re doing the exam on someone else, support their arm with your free hand.
2. Do the exam with three fingers of your dominant hand. Use your three middle fingers to feel for lymph nodes. Do not use your thumb, which is less sensitive. Feel with the pads of your fingers – where your fingerprints are.
   • If you’re palpating someone else’s axillary nodes, use your right hand to check their left armpit, and your left hand to check their right armpit.
3. Press deeply in a circular motion. Your axillary nodes are rather deep into your armpit, so press in with firm, slow pressure. Move the pads of your fingers around in a circular motion. When you move your fingers to a different area, do it slowly and while exerting gentle pressure against the body.
4. Feel the four points of a diamond in your armpit. Start feeling for lymph nodes with your hand straight up, deep in your underarm, at the bottom middle of your armpit. Then feel three other points, making the shape of a diamond:
   • Move your hand up and towards your chest, feeling underneath where your chest muscles (pectorals) reach your armpit.
   • Move across your armpit horizontally towards your back, and feel under where your scapula (shoulder blade) reaches your armpit.
   • Move up and to the middle of your armpit to where your arm joins your armpit, and feel for nodes with the palm of your hand facing the bottom of your arm.

Following Up on Palpable Lymph Nodes

1. Take notes on what you feel. When you feel a swollen lymph node, write down what you feel. Take this to your doctor so they can make comparisons over time, then keep it handy so you can keep track of any changes. Write down the following information:
   • The size: estimate to the closest centimeter, or use a ruler to measure from one side to the other.
   • The shape: is it round, oval, or irregularly shaped?
   • The firmness: is it soft when you gently press it, or firm and rubbery? Roll your fingers over the node with slight pressure.
   • The mobility: if you try to wiggle it gently, does it move around a bit or is it firmly fixed in place?
   • Tenderness: is the lymph node sore or tender at all?
2. Get large, firm, fixed nodes check out. If you feel a lymph node in your armpit that is less than 3cm, soft, and moveable, don’t worry about calling your doctor. These rarely indicate a problem. On the other hand, swollen nodes might mean you have inflammation, an infection, or another problem. Call your doctor for a check-up if the enlarged lymph nodes you feel are any of the following:
   • Fixed (not moveable)
   • Firm
   • Persistent (it’s normal for nodes to get big for under a week then go back to normal)
3. Schedule a doctor’s appointment to get checked out. See your doctor if you have an alarming enlarged node that lasts longer than a week. They will talk to you about your medical history and do a physical exam. Depending on what they find, they may have you schedule an appointment for an ultrasound or mammogram. Follow-up with these tests like your doctor says to make sure there’s no problem that needs further monitoring or treatment.

Tips

• Trim your fingernails short before feeling for axillary nodes, so you don’t cut or scratch yourself.

Sources and Citations

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