A new report published by the American Cancer Society recommends training health care providers in a standardized version of clinical breast exam to find palpable cancers.
A committee of nationally recognized experts convened by the American Cancer Society in collaboration with the U.S. Centers for Disease Control and Prevention offers this and other recommendations in a report published in CA: A Cancer Journal for Clinicians. The recommendations could help standardize the practice of clinical breast exam and lead to better evidence to show the effectiveness of clinical breast exam in the early detection of breast cancer.
Clinical breast examination, or CBE, is an examination of the breasts by a health care professional to find palpable cancers early, when there are more treatment options and there may be a better chance for survival. Various methods of CBE are practiced widely. A 2003 study showed 90 percent of women 40 or older had received a CBE at some time, with about 75 percent having received one in the previous year.
In its report, the committee also recommends standardizing the interpretation and reporting of CBE findings to improve accuracy and consistency. A lack of standard reporting, terms and formats for documentation could prove to be impediments to maximizing the benefits of clinical breast exams, according to the authors. "Thus, even if CBE were performed uniformly to its highest potential sensitivity and specificity, differences in interpretation and how findings are reported limit the potential benefits of this exam to guide further evaluation and lead to the earlier treatment of breast cancer," report authors noted.
"This recommendation represents national recognition that our program is on the forefront of medical education and early detection," said Donald Austin, M.D., director of the Breast Health Education Program (BHEP) of the Oregon Health & Sciences University Cancer Institute. According to Austin, the OHSU medical school has the nation's only academic program that currently offers training matching this recommendation at all levels of medical education.
"It is not possible to find breast cancer at its earliest stages the way most clinicians perform clinical breast exams," said Elizabeth Steiner, M.D., associate director of the BHEP and research assistant professor of family medicine in the OHSU School of Medicine. "Breast cancer remains the most common cancer among American women and is the second leading cause of cancer deaths in women, yet most physicians report they have received little if any instruction on how to conduct a complete breast exam."
SOURCES:
CA: A Cancer Journal for Clinicians, November/December 2004
Oregon Health & Science University (http://www.osu.edu)
American Cancer Society (http://www.cancer.org)
