What is a clinical breast exam (CBE)?
A clinical breast exam (CBE) is a physical exam done by a health care
provider as part of your regular medical check-up. Your provider should
carefully feel your breasts and underarm for any changes or abnormalities (such
as a lump). He/she should visually check your breasts while you are sitting up
and physically examine your breasts while you are lying down. It is important to
ask for a CBE if one is not offered at your check-up.
Who should perform a clinical breast exam?
A CBE should be performed by a health care provider well trained in the
technique (this may be a physician, nurse practitioner or other medical staff).
However, not all providers may have this training.
At what age should I start getting clinical breast exams?
Starting at age 20, CBE is part of routine breast cancer screening for women.
When you begin having mammograms, CBE complement these screenings.
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 age 20, and
every year starting at age 40
Sign up for your screening reminder at komen.org/reminder
3. Know what is normal for you and see your health care provider if you
notice any of these breast changes:
Lump, hard knot or thickening inside the breast or underarm area
Swelling, warmth, redness or darkening of the breast
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
Limit menopausal hormone therapy (postmenopausal hormone use)
Breastfeed, if you can
Accuracy of clinical breast exam
CBE can be helpful in finding tumors in women under age 40 (for whom
mammography is not recommended).
In women ages 40 and older, CBE combined with mammography may find more
cancers than mammography alone. When used together at yearly check-ups, fewer
breast cancers are missed. Although an important complement to mammography, CBE
is not a substitute for mammograms in women 40 and older.
Most health organizations recommend CBE as a part of regular breast cancer
screening. However, there are some drawbacks to its use. One downside is the
increased chance of false positive results that require follow-up tests. False
positives occur when a CBE finds something that looks or feels like cancer, but
turns out to be benign (not cancer). One large study found the chance of having
a false positive result after 10 yearly CBE was about 20 percent.
Thinking a false positive result may be breast cancer until cancer is ruled
out can cause fear and worry. However, this does not outweigh the life-saving
benefits of regular screening.