Does adding clinical breast examination to mammography improve the accuracy of breast screening?

Researchers compared the accuracy of screening among centers that offered clinical breast examination in addition to mammography with that of centers that offered only mammography

These researchers found that the sensitivity of referrals was higher for women who were screened at centers that offered clinical breast examination and mammography than for women who were screened at centers that did not offer clinical breast examination. However, women without cancer who were screened at centers that offered clinical breast examination had a higher false-positive rate than women screened at centers that offered only mammography.

“Overall, we found higher breast cancer detection rates and sensitivities for clinical breast examination referral than those previously found in other community-based studies, which suggests that the accuracy of clinical breast examination can be improved in screening programs that offer high-quality [clinical breast examinations] by specially trained nurses,” the authors write. However, they note, the benefits of adding clinical breast examination must be weighed against potential risks and costs due to false-positive results and the anxiety associated with additional evaluations.

“More answers are needed on the role of clinical breast examination in breast cancer screening before definitive recommendations for or against its use can be made,” they write. “While we wait for those answers, the data found by the studies suggest that clinical breast examination must be done well if it is to be done at all, with the acknowledgment that overall referrals and false-positive results will increase.”

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