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Mammography is the primary tool for breast cancer screening, and the roles of the clinical breast examinations and breast self-examinations have been questioned by some experts. The 2009 U.S. Preventive Services Task Force report on breast cancer screening states that “current evidence is insufficient to assess the additional benefits and harms of clinical breast examinations beyond screening mammography in women 40 years and older”. The data evaluated by the U.S. Preventive Services Task Force in its 2009 recommendation suggest that teaching breast self-examination does not reduce the mortality rate of breast cancer and it recommends against clinicians teaching women how to perform breast self-examination. However, 8–17% of cases of breast cancer are missed by mammography.
The clinical breast examination and breast self-awareness, which may include breast self-examination, have the potential to detect a palpable cancer. Some studies show that clinical breast examination and mammography together have a better sensitivity than mammographic screening alone for detecting breast cancer). Thus, a breast examination and mammography performed by your physician still is recommended as part of the periodic health examination of women, especially those with known risk factors for breast cancer.
An annual visit with your obstetrician/gynecologist, provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. The annual health assessment should include screening, evaluation and counseling, and immunizations based on age and risk factors. The interval for specific individual services and the scope of services provided may vary in different ambulatory care settings. The performance of a physical examination is a key part of an annual visit, and the components of that examination may vary depending on the patient’s age, risk factors, and physician preference. Speak with your physician about what elements of the annual exam make sense for your health.