Answers About Clinical Breast Exams Are Mixed

Knowing how to take care of yourself is an important thing we learn as children. That continues as we get older, yet the information can become a bit confusing.

As women, we know that we should get a mammogram every year after the age of 40. In our 20s and 30s we have been instructed to conduct self breast exams and contact a health care provider if we feel anything strange.  But the guidelines for clinical breast exams has shifted, creating some confusion.

“People generally agree that a clinical breast exam can detect some cancers that may not be seen on mammograms,” said resident Ann Edwards, a nurse practitioner and assistant professor at Michigan State University’s nurse practitioner graduate program. “This could be especially helpful for women in their 20s and 30s who are not going to be getting a mammogram every year.

“My opinion is that women over 40 should also have a clinical breast exam every year. Many groups – the American Cancer Society, Susan G. Komen and the American College of Gynecologists – all recommend them. Still, many of the studies do show that as a preventative measure, the evidence says it’s insufficient to recommend for or against clinical breast exams. It’s really a mixed bag.”

Many gynecologists will perform a breast exam at your yearly visit. But that, Edwards warns, does not mean you are getting a quality clinical exam. As a former breast specialist at the Alexander Walt Breast Center at the Karmanos Cancer Institute, Edwards often saw patients whose GYNs had recommended them for follow-up after they found something troubling during an exam. Many of these suspicious masses were nothing, but did indicate that the GYN did not know how to conduct a proper breast exam.

“You might have clinicians who aren’t real skilled, and they think they feel something,” Edwards said. “That can result in unnecessary testing, such as additional mammogram views or ultrasound.”

Edwards strongly recommends that you ask your GYN how he or she learned how to do a proper breast exam. Mammacare is a new method being taught, which helps health care providers better discern between normal breast tissue and suspicious masses. Formal training is not the only way to learn; many doctors have practiced correct breast exam techniques for years.

“On the positive side, having a clinical breast exam is often calming for women, as long as the practitioner is skilled,” Edward said.

To find a practitioner who is skilled at clinical breast exams, Edwards recommends you contact someone who specializes in breast health. She also recommends spacing out your mammogram and your clinical breast exam by about six months so that you are addressing your breast health twice a year instead of doing everything at once.