The piano player and the physical examination

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