Dear patient, when it comes to your gynecological health, there are two main areas of concern that many women present with: the breast and the pelvis. As a result, these areas are often the focus of close examination and evaluation.
One type of examination is self-breast examination (SBE), where you examine your own breasts to detect any abnormalities. However, clinical breast examination (CBE) is completed by a healthcare professional and can identify a small portion of breast malignancies that may not be detected by mammography. It may also identify cancer in young women who are not yet eligible for mammography.
Although SBE and CBE are commonly performed, studies have shown that they can lead to an increase in diagnostic testing for benign breast diseases and do not effectively lower the breast cancer mortality rates. As a result, some organizations have removed SBE and CBE from their recommended screening practices. The American College of Obstetricians and Gynecologists, however, still encourages breast self-awareness, which includes paying attention to changes in breast appearance and architecture, and may include SBE. For women ages 20 to 39, it is recommended to receive a CBE every 1 to 3 years, and once a year after age 40.
During a CBE, your breasts will first be examined as you sit on the edge of an examination table with your hands at your hips and chest muscles flexed. This position will highlight any asymmetry in your breasts. The skin of your breasts will then be inspected for redness, retraction, scaling, and edema. The contours of your breasts and axilla will also be observed for symmetry. Your axillary, supraclavicular, and infraclavicular lymph nodes will then be palpated with the help of the examining healthcare professional.
You will then be asked to lie down on the examination table and place one hand above your head to stretch your breast tissue across your chest wall. The examination will include the entire breast tissue within a pentagonal area defined by the clavicle, sternal border, inframammary crease, and midaxillary line. The healthcare professional will use the finger pads in a continuous, circular rolling motion to palpate the entire breast tissue.
It is important to note that during the CBE, there is no need to intentionally express nipple discharge unless you have previously reported a spontaneous discharge. If any abnormal findings are detected, they will be described based on their location in the right or left breast, clock position, distance from the areola, and size.
You should be aware of any new masses in your axilla or breast, non-cyclic breast pain, spontaneous nipple discharge, new nipple inversion, and changes in your breast skin such as dimpling, scaling, ulceration, edema, or redness. This constitutes breast self-awareness and if you experience any of these symptoms, you should seek evaluation. If you wish to perform SBE, we will provide you with the benefits, limitations, and potential harms, as well as instructions on how to complete the examination after your menstrual period.
Responses