Clinical breast exams are physical exams done by physicians, nurse practitioners or other trained medical staff. They involve looking at and feeling the breasts and underarm for any changes or abnormalities. The breasts should be checked while you are sitting up and while you are lying down.
Clinical breast exams are a part of breast cancer screening and should be thought of as a complement to mammography. See Figure 3.1 for a list of breast cancer screening recommendations from several major health organizations.
Although clinical breast exams are simple tests that should be done as part of a routine medical checkup, not all health care providers are well trained in the technique. It is important to ask for a clinical breast exam if one is not offered.
Komen recommends...
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Susan G. Komen for the Cure® recommends that you :
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 20, and every year starting at 40
3. Know what is normal for you and see your health care provider right away if you notice any of these breast changes:
- Lump, hard knot or thickening
- Swelling, warmth, redness or darkening
- 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
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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. (Learn more about 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.
Updated 10/05/09
