Breast Investigators

Source: Mount Nittany Medical Center

CLINICAL BREAST EXAM

Your yearly checkup should include a clinical breast exam. This exam may be done by a gynecologist, family doctor, nurse practitioner, or specially trained nurse. Yearly breast exams help to ensure that breast conditions are found early.

Your Healthcare Provider’s Role

A healthcare professional knows the tests and follow-up care needed if a problem is found. Your clinical exam is also a great time to ask questions about breast self-exam (BSE). You can find out whether you’re doing BSE in the most effective way. Or you may want to ask how pregnancy, breast implants, or breast reduction surgery affects the way you should examine your breasts.

Diagnostic Tests

If a clinical exam reveals a breast change, you may have other tests to find out more.
These tests may include:
• Mammography, low-dose x-rays used to create pictures of the breast.
• Ultrasound, using sound waves to create a picture of the breast.
• Biopsy, the removal of a small amount of breast tissue by needle or incision. The tissue is then examined under a microscope.

Guidelines for Having Clinical Breast Exams

Starting at age 20, you should have a clinical breast exam every 1 to 3 years. After age 40, have a clinical breast exam each year. If you’re at higher risk for breast cancer, you may need more frequent exams.
Risk factors for breast cancer may include:
• Being over 50 or postmenopausal
• A family history of breast cancer
• Having had no pregnancies or a first pregnancy after age 30
• Obesity
• Heavy alcohol use

 

Source: Susan G. Komen for the Cure

Accuracy of Clinical Breast Exam

Clinical breast exam can be helpful in finding tumors among women under age 40 for whom mammography is not recommended. After age 40, clinical breast exam combined with mammography can detect more cancers than mammography alone. When used together at yearly checkups, fewer breast cancers are missed [26]. Although an important complement to mammography, clinical breast exams are not a substitute for mammograms in women 40 and older.
Although most health organizations recommend clinical breast exam as a part of regular breast cancer screening, there are some drawbacks to its use. One downside is the increased chance of false positive results that require follow-up tests. False positives occur when a clinical breast exam shows something abnormal that turns out to be benign. One large study found that the chance of having a false positive result after 10 clinical breast exams was a little over 20 percent [27]. Thinking that a false positive result is breast cancer can cause fear and worry. However, this does not outweigh the life-saving value of regular screening.