The clinical breast exam (CBE)is the physical examination of the breast that is performed by a health care provider. The clinical breast exam can be performed in conjunction with the mammogram in the detection of breast cancer. In addition, the physical exam of the breast is used to rule out other conditions and problems of the breast. The clinical breast exam may be included in a routine medical check-up, however, the patient's health care provider may decide how often it should be performed. Frequently, the doctor or nurse will instruct the patient on the correct technique of performing a CBE so she can perform breast exams in between regular office visits.
Typically, aside from the routine breast exam, the CBE may be performed when a lump is found in the breast or if the patient is experiencing nipple discharge in one or both of the breasts. Although nipple discharge typically indicates hormonal fluctuations, it can signify a more serious pathology, such as a tumor. In addition, any new changes or irregularities in the breast, such as inverted nipples may warrant a clinical breast exam. Generally, pain in the breast is benign, however, it may signal new tissue growth or infection, and should be addressed. Often, women who have breast implants may need to be extra vigilant about examining their breasts, as lumps may be more difficult to detect.
Generally, the clinical breast exam is performed in the office of the health care provider. The patient will be asked to disrobe above the waist and will put on a gown. Prior to the breast exam, the patient should tell her health professional if she has noticed any areas of irregularities in her breasts. Next, the patient will lie down on the exam table, and the doctor or nurse will begin examining each breast. The CBE should also include underarm and collarbone palpation, as well as a visual inspection of the breasts. Typically, a dominant lump in the breast or nipple retraction will warrant further medical evaluation.
Usually, a clinical breast exam is not painful, however, it may feel uncomfortable because deep palpation is often necessary to adequately examine breast tissue. Generally, it is normal for the breasts to feel lumpy or tender, especially at the time of menstruation. If the clinical breast exam reveals an abnormality, the health care provider may recommend further testing that may include a mammogram, ultrasound or a breast biopsy to rule out serious pathology.