Clinical Breast Examination

	Test Overview
	Why It Is Done
	How To Prepare
	How It Is Done
	How It Feels
	Risks
	Results
	What Affects the Test
	What To Think About
	References
	Credits
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A clinical breast examination (CBE) is a physical examination of the breast done by a health professional. Clinical breast examinations are used along with mammograms to check women for breast cancer. Clinical breast examinations are also used to check for other breast problems.

Medical experts disagree about the need for regular clinical breast examinations. Some doctors recommend regular CBE. However, the U.S. Preventive Services Task Force (USPSTF) says that studies do not show support for or against regular CBE. Some studies show that mammogram tests alone reduce breast cancer deaths just as well as using mammograms and CBE.

A clinical breast examination may be part of your regular checkup. Talk with your health professional about how often you need a breast examination.

Breast implants do not change a woman's chance of getting breast cancer, so women with breast implants should also have regular clinical breast examinations.

A clinical breast examination is done to:

• Find a lump or change in the breast that may mean a serious problem is present, such as breast cancer.
• Check other breast problems that may need more treatment, such as mastitis or a fibroadenoma.

Tell your health professional if you:

• Have a new lump or change in your breasts. This includes a change in the way your nipples look or if you have any nipple discharge.
• Some women have nipples that sink into the breast, called inverted nipples. For these women, this is normal. But if you do not have inverted nipples and notice a change where your nipple becomes inverted, tell your doctor.
• Have pain in one breast, especially if the pain is not related to having your menstrual period.
• Are or might be pregnant.
• Are breast-feeding.
• Have breast implants.
• Have had a breast biopsy.
• Have completed menopause.
• Are taking hormone replacement therapy.
• Have a personal or family history of breast cancer.

You may want to have your examination 1 to 2 weeks after your menstrual period ends, if you are still menstruating; your breasts are less likely to be tender at that time.

Talk to your health professional about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

A clinical breast examination is done by a health professional. You will need to take off your clothes above the waist. You will be given a gown to wear during the examination.

First, your health professional will ask you questions about any problems you may have, your medical history, and your risk factors for breast cancer. Talk to your health professional about any areas of your breasts you may be concerned about.

Your health professional will then examine each breast, underarm, and collarbone area for changes in breast size, skin changes, or signs of injury or infection, such as bruising or redness. You may be asked to lift your arms over your head, put your hands on your hips, or lean forward and press your hands together to tighten the muscle beneath each breast during this part of the examination. You may also lie flat on the table and put your arm behind your head while your health professional checks your breast tissue.

Your health professional will feel (palpate) each breast for any unusual or painful areas or for a dominant lump. A dominant lump in the breast is any lump that is new, larger, harder, or different in any other way from other lumps or the rest of the breast tissue.

Your health professional will gently press on the breast tissue from about 1 in (2.5 cm) below the breast up to the collarbone. He or she also will examine your armpit (axillary area) and your neck for swollen glands (lymph nodes). Your health professional will likely press gently on your nipple to check for any discharge.

After the examination, your health professional may teach you how to examine your own breasts (breast self-examination) and help you practice doing it. Regular breast self-examination has not been shown to be helpful for finding early breast cancers.

A clinical breast examination normally does not cause any discomfort unless your breasts are tender.

There are no risks in having a clinical breast examination.

A clinical breast examination (CBE) is a physical examination of the breast done by a health professional. Findings of a clinical breast examination may include the following.

If a breast problem is found, the next step depends on the problem.

• Cyclic breast pain, fibrocystic changes, or cysts may just be rechecked to see if they change or go away on their own. Cysts may also be checked by ultrasound or drained with a needle (aspirated) to make sure they are cysts and to help relieve pain.
• A mammogram, magnetic resonance imaging (MRI), or ultrasound may be needed if a lump is found. Breast tissue may be taken out with a needle (needle aspiration or core biopsy) or through a small cut (biopsy) to be looked at under the microscope.
• Nipple discharge, especially if it is spontaneous or bloody, may be looked at under a microscope for unusual cells.

Reasons you may not be able to have the test or why the results may not be helpful include:

• Your menstrual cycle. The changes in your body that occur during your menstrual cycle may make your breast tissue feel or look different.
• Having fibrocystic lumps. Fibrocystic lumps make a clinical breast examination hard to do because many lumps are present in the breast.

• If you have breast pain when you have your periods (cyclic breast pain), see the topic Breast Pain (Mastalgia).
• A normal clinical breast examination does not mean that breast cancer is not present. Depending on your age and your personal and family history of breast cancer, your health professional may do other tests, such as a mammogram.

Other Works Consulted

• American Cancer Society (2008). Cancer Facts and Figures 2008. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/STT/content/STT_1x_Cancer_Facts_and_Figures_2008.asp.

• Saslow D, et al. (2004). Clinical breast examination: Practical recommendations for optimizing performance and reporting. CA: A Cancer Journal for Clinicians, 54: 327–344.