Is clinical breast examination important for breast cancer detection?

Current oncology

E. Poirier²  C. Desbiens⁴  C. Diorio⁴  J.C. Hogue⁵  J. Chiquette⁵  M. Joyal⁵  B. Poirier⁶  D. Boudreau⁶  N. Duchesne⁶  L. Provencher⁶ 

[1] Centre de Recherche du chu de Québec–UniversitéLaval;Centre de Recherche du chu de Québec–Université Laval;Université Laval;Centre de Recherche du chu de Québec–UniversitéLaval;Université Laval;chu de Québec– Université Laval

关键词: Breast cancer;    clinical examination;    mammography;    ultrasonography;    screening;    palpable breast masses;   

DOI  :  10.3747/co.23.2881

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

Background Screening clinical breast examination (cbe) is controversial; the use of cbe is declining not only as a screening tool, but also as a diagnostic tool. In the present study, we aimed to assess the value of cbe in breast cancer detection in a tertiary care centre for breast diseases. MethodsThis retrospective study of all breast cancers diagnosed between July 1999 and December 2010 at our centre categorized cases according to the mean of detection (cbe, mammography, or both). A cbe was considered “abnormal” in the presence of a mass, nipple discharge, skin or nipple retraction, edema, erythema, peau d’orange, or ulcers. ResultsDuring the study period, a complete dataset was available for 6333 treated primary breast cancers. Cancer types were ductal carcinomain situ(15.3%), invasive ductal carcinoma (75.7%), invasive lobular carcinoma (9.0%), or others (2.2%). Of the 6333 cancers, 36.5% ( n= 2312) were detected by mammography alone, 54.8% ( n= 3470) by mammography and cbe, and 8.7% ( n= 551) by physician-performed cbe alone (or 5.3% if considering ultrasonography). Invasive tumours diagnosed by cbe alone were more often triple-negative, her2-positive, node-positive, and larger than those diagnosed by mammography alone ( p< 0.05). ConclusionsA significant number of cancers would have been missed if cbe had not been performed. Compared with cancers detected by mammography alone, those detected by cbe had more aggressive features. Clinical breast examination is a very low-cost test that could improve the detection of breast cancer and could prompt breast ultrasonography in the case of a negative mammogram. 

【 授权许可】

Unknown