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Breast exams refer to the routine examination of breast tissue to look for lumps or other changes that might indicate cancer. There are two categories of breast exams: Breast Self Exam (BSE) and Clinical Breast Exam (CBE). BSE refers to self-examination of the breasts on a regular (usually monthly) basis, using a systematic method to examine all the breast tissue. Studies have looked at whether Breast Self Exam lowers the risk of death by breast cancer. One large randomized study involving 266,000 women found no reduction in breast cancer death in a 10-year period in women who were taught to perform monthly breast exams. The same research discovered women who practiced regular SBE had more biopsies and procedures for benign lumps than women who did not. Based on this data, some expert panels, including NCCN, do not recommend BSE as a standard recommendation for breast cancer screening for women in the general population.
There has been no similar study on BSE in high-risk women. Current NCCN recommendations for women with hereditary breast cancer risk include BSE training and monthly BSE in women beginning at age 18.
CBE refers to examination of a patient’s breasts by a health care professional to detect lumps or other abnormalities. In one study CBE was combined with other screening tools to detect breast cancer in BRCA carriers. Used alone, CBE was found to be an ineffective method of finding cancers. However, when combined with mammography, CBE improved the chances of finding cancer. The NCCN recommends a twice-yearly clinical breast exam for high-risk women beginning at age 25.