Does This Patient Have Breast Cancer? The Screening Clinical Breast Examination: Should It Be Done? How?

Barton, Mary B.; Harris, Russell; Fletcher, Suzanne W.

doi:10.1097/00006254-200007000-00017

Cited by 122 publications

(186 citation statements)

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“…Due to altered ECM microstructure and crosslinking, the increased stiffness of breast tumors is so different from the surrounding tissue that manual palpation remains an important diagnostic [90]. Tumor stiffness, assessed with ultrasound elastography or atomic force microscopy appears to increase with increasing grade [91] and predicts poorer prognosis [92].…”

Section: Microstructure Biomechanics and Crosslinkingmentioning

confidence: 99%

The extracellular matrix in breast cancer predicts prognosis through composition, splicing, and crosslinking

Robertson

2016

Experimental Cell Research

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The extracellular matrix in breast cancer predicts prognosis through composition, splicing, and crosslinking a b s t r a c tThe extracellular matrix in the healthy breast has an important tumor suppressive role, whereas the abnormal ECM in tumors can promote aggressiveness, and has been linked to breast cancer relapse, survival and resistance to chemotherapy. This review article gives an overview of the elements of the ECM which have been linked to prognosis of breast cancers, including changes in ECM protein composition, splicing, and microstructure. Published by Elsevier Inc.

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Section: Microstructure Biomechanics and Crosslinkingmentioning

confidence: 99%

The extracellular matrix in breast cancer predicts prognosis through composition, splicing, and crosslinking

Robertson

2016

Experimental Cell Research

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“…In addition, the behavioral assessment of exam duration highlights a novel tool for studying actual BSE (and other health) behavior, in addition to assessing self-reports of future (i.e., intentions, as in Study 1) or past (i.e., compliance) behavior, as is more typical in health research. Although more research is necessary to examine how this dependent variable maps onto behavioral compliance, there is evidence that shorter duration exams are less thorough (e.g., Barton, Harris, & Fletcher, 1999;Fenton et al, 2005). In applying what is already an established precedent outside of health psychology (i.e., assessing the degree of a psychological threat by measuring the duration that one endures it, e.g., Wicklund & Frey, 1980;Thorpe & Salkovskis, 1995), the current research offers methodological as well as conceptual advances.…”

Section: Conceptual Issuesmentioning

confidence: 99%

Uncovering an existential barrier to breast self-exam behavior

Goldenberg

Arndt

Hart

et al. 2008

Journal of Experimental Social Psychology

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The present research applies an analysis derived from terror management theory to the health domain of breast examination, and in doing so uncovers previously unrecognized factors that may contribute to women's reluctance to perform breast self-examinations (BSEs). In Study 1, when concerns about mortality were primed, reminders of human beings' physical nature (i.e., creatureliness) reduced intentions to conduct BSEs compared to reminders of humans' uniqueness. In Study 2, women conducted shorter exams on a breast model (an experience found to increase death-thought accessibility) when creatureliness was primed compared to a uniqueness and no essay condition. In Study 3, after a creatureliness prime, women performed shorter BSEs when a placebo did not provide an alternative explanation for their discomfort compared to when it did. Advances for theory and breast self-exam promotion are discussed."The body, then, is one's animal fate that has to be struggled against … the creatureliness is the terror" Ernest Becker (The Denial of Death, 1973, pp. 44, 87) Breast cancer is the most common cancer among women, and the second leading cause of cancer deaths in women today (American

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“…A meta-analysis demonstrated that CBE contributed to cancer detection independently from mammography, with sensitivity and specificity of CBE estimated at 54 % and 94 %, respectively. 7 It should be noted that this calculation was based on pooled data in which the method of CBE varied from study to study. In community based studies, without the implementation of standard breast exam guidelines, CBE detected about 5 % of cancers that were not visible on mammography.…”

mentioning

confidence: 99%

“…The sensitivity and specificity of CBE was calculated at 51.7 % and 94.3 %, respectively, 15 which is consistent with that in other studies. 7 It is not yet known whether diagnosing these cancers will change outcomes. Mortality data will be forthcoming.…”

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confidence: 99%

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The Clinical Breast Exam: A Skill that Should Not Be Abandoned

Bryan

Snyder

2013

J GEN INTERN MED

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The clinical breast exam (CBE) is an important tool in the care of women. However, the utility of the screening CBE has been called into question. This article discusses the importance of the CBE as a physical diagnosis tool. Recommendations regarding screening with CBE are reviewed, and evidence surrounding breast cancer screening using CBE is briefly summarized. Clinicians should strive to provide high quality CBEs as part of the general clinical exam for women, particularly those who present with breast complaints, and for patients who choose to have CBE screening. In conclusion, there is a role for the CBE in the care of women, and clinicians should be proficient at performing these exams. Simulation teaching technologies are now available at Department of Veteran Affairs (VA) facilities to enable clinicians to improve their CBE skills. T he clinical breast exam (CBE) is an important tool in the care of women. It is utilized for the evaluation of breast complaints and, more controversially, in breast cancer screening. The Department of Veteran Affairs (VA) Women's Health Services Office has recently coordinated the distribution of breast exam simulation equipment to VA facilities in order to enhance CBE competency training for VA providers. Since the utility of the screening CBE has been called into question, 1 the issue may be raised as to whether this training is pertinent. The following summary will provide rationale that the CBE is an important physical diagnosis skill that should not be discarded, and that simulation equipment is a helpful tool in training clinicians.Clearly, the CBE is required for the evaluation of patients with breast complaints, particularly those with a breast lump. In one study of primary care clinics, 11 % of women complaining of a breast lump and 4 % of women with any breast complaint were found to have a malignancy. 2 In addition, a significant number of patients with breast cancer present with a palpable breast mass. Haakinson et al. 3 reported that 34 % of women with invasive breast cancer initially presented with a palpable lesion. 13 % of the women with a palpable breast mass who were found to have invasive cancer had a normal mammogram within the previous year. Likewise, a large study of diagnostic mammograms reported that the sensitivity of mammography in women with a self-reported breast lump was 87.3 %. 4 This suggests that approximately 13 % of clinically evident breast cancers may be missed by mammography imaging. Therefore, identifying these tumors by palpation is a pertinent clinical issue, and providers should be proficient at discerning abnormal breast findings.The more divisive issue is whether the clinical breast exam should be used in conjunction with mammography for breast cancer screening in asymptomatic patients. The US Preventive Services Task Force (USPSTF) states that there is insufficient evidence to recommend for or against routine screening with the CBE. 1 However, the American Cancer Society 5 and the American College of Obstetricians and Gynecologist...

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Does This Patient Have Breast Cancer? The Screening Clinical Breast Examination: Should It Be Done? How?

Cited by 122 publications

References 59 publications

The extracellular matrix in breast cancer predicts prognosis through composition, splicing, and crosslinking

The extracellular matrix in breast cancer predicts prognosis through composition, splicing, and crosslinking

Uncovering an existential barrier to breast self-exam behavior

The Clinical Breast Exam: A Skill that Should Not Be Abandoned

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