Recently we have been in the Diagnostic Error Meeting in Washington, DC. There the Professor of Surgery of Stanford University Dra. Carla M. Pugh, showed the importance of a correct clinical examination and palpation to detect a lump in the breast. Force and the technique of examination is important. There is one technique what is less effective to detect a lump in the breast, the piano player technique.
We consider that this concept is also important to detect cervical and supraclavicular lymph nodes.
You can see a video here