What is a clinical breast exam (CBE)?
A clinical breast exam (CBE) is a physical exam done by a health care provider as part of your regular medical checkup. Your provider should carefully feel your breasts and underarm for any changes or abnormalities (such as a lump). He/she should visually check your breasts while you are sitting up and physically examine your breasts while you are lying down.
Who should perform a clinical breast exam?
A CBE is performed by a health care provider well trained in the technique (this may be a physician, nurse practitioner or other medical staff). Not all providers have this training, so it is important to ask for a CBE if one is not offered.
At what age should I start getting clinical breast exams?
Starting at age 20, CBE is part of routine breast cancer screening for women. When you begin having mammograms, CBE complement these screenings.
Figure 3.1 lists the breast cancer screening guidelines from several major health organizations.
Susan G. Komen for the Cure® recommends that you :
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1. Know your risk
- Talk to your family to learn about your family health history
- Talk to your health care provider about your personal risk of breast cancer
2. Get screened
- Ask your health care provider which screening tests are right for you if you are at higher risk
- Have a mammogram every year starting at age 40 if you are at average risk
- Have a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40
3. Know what is normal for you and see your health care provider if you notice any of these breast changes:
- Lump, hard knot or thickening inside the breast or underarm area
- Swelling, warmth, redness or darkening of the breast
- Change in the size or shape of the breast
- Dimpling or puckering of the skin
- Itchy, scaly sore or rash on the nipple
- Pulling in of your nipple or other parts of the breast
- Nipple discharge that starts suddenly
- New pain in one spot that doesn't go away
4. Make healthy lifestyle choices
- Maintain a healthy weight
- Add exercise into your routine
- Limit alcohol intake
- Limit postmenopausal hormone use
- Breastfeed, if you can
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Accuracy of clinical breast exam
CBE can be helpful in finding tumors in women under age 40 (for whom mammography is not recommended).
In women ages 40 and older, CBE combined with mammography may detect more cancers than mammography alone. When used together at yearly check-ups, fewer breast cancers are missed [28,46]. Although an important complement to mammography, CBE is not a substitute for mammograms in women 40 and older.
Most health organizations recommend CBE as a part of regular breast cancer screening. However, there are some drawbacks to its use. One downside is the increased chance of false positive results that require follow-up tests [29,46]. False positives occur when a CBE shows something that looks like cancer, but turns out to be benign (not cancer). One large study found that the chance of having a false positive result after 10 yearly CBE was a little over 20 percent [29].
Thinking a false positive result is breast cancer until cancer is ruled out can cause fear and worry. However, this does not outweigh the life-saving value of regular screening.
Updated 08/22/11
