Test Overview
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 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.
Why It Is Done
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.
How To Prepare
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?).
How It Is Done
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.
How It Feels
A clinical breast examination normally
does not cause any discomfort unless your breasts are tender.
Risks
There are no risks in having a clinical breast
examination.
Results
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.
Clinical breast examination| Normal: | The nipples, breast tissue, and areas around the breast
look normal and are normal in size and shape. One breast may be slightly larger
than the other. |
|---|
A small area of firm tissue may be present in the lower
curve of the breast below the nipple. |
Tenderness or lumpiness that occurs in both breasts is
normal for many women. Many women have the same lumpiness or thickening in both
breasts during the menstrual cycle. |
A clear or milky discharge (galactorrhea) may be present
when the nipple is squeezed. This may be caused by nursing, breast stimulation,
hormones, or some other normal cause. |
One breast may have more glandular tissue (lumps) than the
other one, especially in the upper outer quadrant of the breast. |
| Abnormal: | A firm lump or area of thickening may be present in one of
your breasts. |
|---|
Changes in the color or feel of your breast or nipple may
be present. This can include wrinkling, dimpling, thickening, or puckering or
an area that feels grainy, stringy, or thickened. |
A nipple may sink into the breast. A red, scaly rash or
sore may be found on the nipple. |
Redness or warmth over a painful lump or over an entire
breast may be present. This may be caused by an infection (abscess or
mastitis) or cancer. |
A bloody or milky discharge (galactorrhea) may occur
without stimulation (spontaneous). |
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.
What Affects the Test
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.
What To Think About
- 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.
References
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.
- American Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.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.
- U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | C. Dale Mercer, MD, FRCSC, FACS - General Surgery |
|---|
| Last Revised | March 30, 2010 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.