Clinical Breast Exam

What is a clinical breast exam?

During a clinical breast exam (CBE), your healthcare provider uses their fingers to feel for lumps or other changes in your breasts. They also look at your breasts to check for changes to your skin or nipples.

A clinical breast exam is one small part of breast cancer screening. It doesn’t replace a mammogram or breast MRI. In fact, these tests are much better at finding breast cancer early than a CBE.

Your primary care physician or gynecologist may offer a clinical breast exam at regular appointments if you’re at average risk for breast cancer. They may recommend a CBE every one to three years starting at age 25, and every year if you’re 40 or older.

Your provider will also do a CBE if you have symptoms of breast changes, like:

• Breast pain
• Skin changes, like dimpling
• Fluid coming out of your nipple
• Lumps
• Big changes in size or shape

What is the difference between a breast self-exam and a clinical breast exam?

A healthcare provider does a clinical breast exam during an appointment. You do a breast self-exam at home. You may get a CBE once a year or so. Breast cancer organizations recommend doing a self-exam once a month to help you detect breast changes.

According to studies, more breast cancer cases are first detected through self-exams than CBEs.

What should I expect during a clinical breast exam?

You can generally expect the following during a clinical breast exam:

1. You sit on an exam table. Your healthcare provider checks your breasts’ appearance. They look at your skin and nipples.
2. Your provider will ask you to lie down. Using their fingertips, your provider gently checks your entire breast, underarm and collarbone area for any lumps or other issues. They also check the lymph nodes near your breast to see if your lymph nodes are bigger than they should be.
3. During the exam, they may ask you to raise your arms over your head, lay them by your sides or press your hands against your hips.
4. Your provider may lightly squeeze your nipples to see if any fluid comes out.

Your provider may also ask you questions about your breasts, like if one has always been bigger or smaller than the other. Most women have one breast that’s slightly larger than the other. This is normal. If you have a nipple difference (like inverted nipples), your provider will typically ask if this is normal for you.

They’ll make note of any changes or suspicious areas they find, if any.

When should I start getting them?

The National Comprehensive Cancer Network recommends starting to get clinical breast exams when you’re 25. Your healthcare provider may recommend a CBE before or after this age based on your breast cancer risk and other factors.

What are the risks of this test?

A clinical breast exam is a safe, non-invasive exam.

The only risk is that it may lead to a false positive result. This means your healthcare provider could find something that looks or feels like cancer, but it later turns out not to be cancer.

A false positive result leads to follow-up tests. This can understandably cause anxiety. But the goal is to catch cancer early, when it’s most treatable. So, you shouldn’t avoid a breast exam to try to prevent a false positive result.

When will I know the results of the exam?

Your healthcare provider will tell you if they saw or felt anything concerning when they’re done with the exam. For most women, the results are normal.

If the results are abnormal, what are the next steps?

If your provider finds something abnormal during a CBE, you’ll need follow-up tests to check if it’s breast cancer or something else. They may recommend any of the following tests:

• Mammogram
• Breast ultrasound
• Breast MRI
• Biopsy

Most abnormal findings from a CBE aren’t breast cancer. This is because many types of breast lumps aren’t cancerous, like fibroadenomas and cysts.

When should I call my doctor?

See a healthcare provider if you notice:

• A lump or other change in how your breast tissue feels
• Irregular or bloody discharge from your nipple
• Dimpling, discoloration or swelling of your breast skin
• Changes in the direction of your nipple, such as turning inward

Keep in mind that things like menstruation can affect the way your breasts look and feel.

Why are clinical breast exams no longer recommended?

It’s not that healthcare providers don’t recommend clinical breast exams. It’s that they’re not the most effective way to screen for breast cancer. Regular mammograms remain the gold standard for detecting breast cancer early.

Various cancer organizations also disagree on whether CBEs are necessary. For example, the American Cancer Society no longer recommends clinical breast exams for cancer screening. But the National Comprehensive Cancer Network does recommend them.