The breast physical examination

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Abstract
Routine physical examination of the female breast for palpable masses or other abnormalities has not always been advocated by health practitioners. Presently, however, the American Cancer Society recommends physical examination of the breasts by a practitioner at 3-year intervals for women 20–40 years old, and at annual intervals for older women. This paper reviews the value of routine physical breast examination as performed by nurses, physicians, and other health care practitioners in the early detection of breast cancer. The sensitivity, specificity, and predictive value of this procedure are summarized. The examination skill of the practitioner as a variable in the detection of lumps and other breast cancer indicators is discussed. Risks and costs of the procedure, along with factors related to women's awareness and compliance with recommended frequency of practitioner breast examinations, are reviewed. Despite notable screening and diagnostic shortcomings, it is argued that the physical examination is a safe, useful, and cost-effective modality for early detection of breast cancer that should be promoted more aggressively by nurses and other health care practitioners.

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