Open AccessClinical Breast Examination: Practical Recommendations for Optimizing Performance and Reporting
Author(s) -
Saslow Debbie,
Hannan Judy,
Osuch Janet,
Alciati Marianne H.,
Baines Cornelia,
Barton Mary,
Bobo Janet Kay,
Coleman Cathy,
Dolan Mary,
Gaumer Ginny,
Kopans Daniel,
Kutner Susan,
Lane Dorothy S.,
Lawson Herschel,
Meissner Helen,
Moorman Candace,
Pennypacker Henry,
Pierce Peggy,
Sciandra Eva,
Smith Robert,
Coates Ralph
Publication year - 2004
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/canjclin.54.6.327
Subject(s) - medicine , breast cancer , mammography , context (archaeology) , asymptomatic , stage (stratigraphy) , clinical practice , gynecology , cancer , intensive care medicine , oncology , family medicine , paleontology , biology
Clinical breast examination (CBE) seeks to detect breast abnormalities or evaluate patient reports of symptoms to find palpable breast cancers at an earlier stage of progression. Treatment options for earlier‐stage cancers are generally more numerous, include less toxic alternatives, and are usually more effective than treatments for later‐stage cancers. For average‐risk women aged 40 and younger, earlier detection of palpable tumors identified by CBE can lead to earlier therapy. After age 40, when mammography is recommended, CBE is regarded as an adjunct to mammography. Recent debate, however, has questioned the contributions of CBE to the detection of breast cancer in asymptomatic women and particularly to improved survival and reduced mortality rates. Clinicians remain widely divided about the level of evidence supporting CBE and their confidence in the examination. Yet, CBE is practiced extensively in the United States and continues to be recommended by many leading health organizations. It is in this context that this report provides a brief review of evidence for CBE's role in the earlier detection of breast cancer, highlights current practice issues, and presents recommendations that, when implemented, could contribute to greater standardization of the practice and reporting of CBE. These recommendations may also lead to improved evidence of the nature and extent of CBE's contribution to the earlier detection of breast cancer.