Overview of Clinical Breast Examination

Breast cancer will affect approximately 178,000 women in 1998 and will be responsible for 30% of all new cancer cases in women (Cady). Over the last several decades the size of tumors detected has decreased dramatically. In addition, it has been reported that the 5-year survival rate for breast cancer when found and treated early is approximately 93% (Landis). This has led to better screening techniques and guidelines for earlier detection with mammography and clinical breast examination (CBE).

The effectiveness of mammography and CBE in detecting early breast cancer has been studied extensively. Since the 1960s several case-control and cohort studies, as well as nine major randomized controlled trials of breast cancer screening, have been conducted. This unparalleled accomplishment in cancer prevention research has included up to 500,000 women. These trials provide scientific evidence that supports breast cancer screening with mammography alone or with CBE for women aged 50 years or older. Although there are no randomized trials of the effectiveness of CBE alone compared with no intervention, there is clear evidence from multiple controlled trials that the combination of mammography with CBE significantly reduces in breast cancer mortality. Therefore, it is crucial that physicians be well trained to perform CBE as an integral component of breast cancer detection.