Clinical- and Self- Breast Exams Are Vital for Breast Cancer Detection

Clinical breast exams and breast self-exams are valuable tools in the fight for breast cancer detection even though they have unclear guidelines.

In a poster presentation during the Society of Breast Imaging/American College of Radiology 2021 Virtual Annual Meeting, Nicole Huang, a fourth-year medical student at the University of Texas Medical Branch, revealed findings that show both clinical and self-exams successfully identify breast cancers even if not all exams are equivalent.

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“There is no significant difference between clinical breast exams and breast self-exams in identifying cancer or positive ultrasound findings,” she said. “Self-breast exams detect cancers. Clinical breast exams are not all equal.”

In fact, she said, based on her findings, clinical breast exams performed by medical doctors, especially female health specialists, are typically more effective than those performed by mid-level providers.

To reach this conclusion, she conducted a retrospective cross-sectional study, reviewing electronic medical records from 462 women who were seen for breast lumps in 2019. She focused on detection of cancer and positive ultrasound findings.

Based on her analysis, 69 of 462 breast masses had positive ultrasound findings, and 26 were ultimately diagnosed as cancer. Of those malignancies, 96 percent were detected via a patient-identified lump, as were 81 percent of ultrasound findings. Medical doctors identified 100 percent of cancers and 92.3 percent of positive ultrasound findings.

Specifically, 25 of 26 breast cancers were initially detected by patients, and only one of 26 was found via clinical breast exam. Still, the evaluation showed that there was no statistically significant difference between clinical breast exams or breast self-exams in identifying cancer or positive ultrasound findings, she said.