CBE

CBE (Clinical Breast Examination)

Clinical Breast Examination (CBE) is a physical examination of the breast performed by a healthcare professional to detect breast abnormalities. It is an essential component of breast cancer screening and is often used in conjunction with mammography and breast self-examination (BSE).

Purpose

The primary purpose of CBE is to identify any signs of breast cancer or other breast conditions. It can help detect lumps, skin changes, or nipple discharge that may indicate the presence of cancer or other breast diseases.

Procedure

A CBE typically involves the following steps:

1. Visual Inspection: The healthcare provider examines the breasts for any visible abnormalities such as asymmetry, skin dimpling, or changes in the nipples.
2. Palpation: The provider uses their hands to feel the breast tissue for lumps or masses. This is done in a systematic manner, often using the pads of the fingers to apply varying pressure.
3. Axillary Examination: The examination includes checking the lymph nodes in the armpit (axilla) for any swelling or tenderness.

Frequency

The recommended frequency of CBE varies depending on guidelines and individual risk factors. Generally, it is recommended for women to have a CBE every 1 to 3 years starting in their 20s and annually after the age of 40.

Effectiveness

The effectiveness of CBE in reducing breast cancer mortality is debated. While it can detect some cancers that mammography might miss, it is not as sensitive as mammography. However, it remains a valuable tool, especially in settings where mammography is not available.

Training

Healthcare providers, including physicians, nurse practitioners, and physician assistants, receive training in performing CBE. Proper technique is crucial for maximizing the sensitivity and specificity of the examination.

Limitations

CBE has limitations, including:

• Subjectivity: The accuracy of CBE can vary depending on the skill and experience of the examiner.
• False Positives/Negatives: There is a risk of false positives, leading to unnecessary anxiety and further testing, as well as false negatives, where a cancer is missed.

Conclusion

CBE is a valuable tool in the early detection of breast cancer, particularly in conjunction with other screening methods. It is important for healthcare providers to be well-trained in performing CBE to ensure the best outcomes for patients.

See Also

• Breast Cancer Screening
• Mammography
• Breast Self-Examination

References

• American Cancer Society. (2023). Breast Cancer Early Detection and Diagnosis. Retrieved from [1]
• National Cancer Institute. (2023). Breast Cancer Screening. Retrieved from [2]