Women's Health

Your Best Breast Cancer Screening Today

The Value of a Doctor's Touch

Leading health groups used to recommend that women visit a doctor's office annually for a clinical breast test, as part of their routine physical exam. Now medical associations do not push for the test, but do see it as a nice complement to mammography.

What happened? As in the breast self exam, authorities determined that there was insufficient scientific evidence to make a strong recommendation for or against the clinical breast exam.

The doctor's inspection actually has the smallest benefit for breast cancer screening, when compared to the mammogram and breast self exam, says Saslow. She says, however, that a standardized process could improve the nature of the test.

"I don't know about you, but when I go to a doctor and I get that exam, it takes about 30 seconds," she says. "You can't do a thorough clinical breast exam in 30 seconds."

Saslow suspects that more breast cancers could be found if medical professionals took more time to conduct the test. She cites a study in Canada that found a strong benefit to clinical breast exams. The Canadian doctors, however, performed 15-minute inspections of each woman's breast, which may be unrealistic under managed care in the US.

A good clinical exam should take at least a couple of minutes, says William Gradishar, MD, spokesman for the American Society for Clinical Oncology. He says the physician should check the appearance and feel of the breasts while the patient is upright, and while lying down on each side. It's also important to look at the neck, and the lymph nodes under the arms.

Three Good Screening Tools

Revised guidelines may highlight the mammogram as the most useful tool in breast cancer screening, but experts say it's a good idea to add self and clinical breast exams into the mix.

After all, says Gradishar, women are most familiar with their breasts, and it's easy to feel your breasts once a month.

Plus, your doctor could notice a lump missed by a mammogram, or could point out an area for a radiologist to examine after an X-ray, says Meissner.

The caveat with the clinical and breast self exams is that they could generate anxiety, most of the time unwarranted. A suspicious finding may turn out to be nothing to worry about at all.

So, use common sense. Check your breasts each month. When you get your annual pap smear, ask your doctor to also check your breasts. And understand that small changes in breast tissue are normal. Don't panic unnecessarily. Just remember this: these tests are part of a comprehensive screening practice, which along with the gold standard mammography, could boost your chances of detecting a potentially deadly disease.