The College guidelines recommend that a pelvic examination be performed on an annual basis in all patients aged 21 years and older.
Clinical Breast Examination
No data exist regarding the ideal age at which to begin clinical breast examinations in the asymptomatic, low-risk patient. Expert opinion suggests that the value of clinical breast examination and the ideal time to start such examinations is influenced by the patient’s age and known risk factors for breast cancer.
The occurrence of breast cancer is rare before age 20 years and uncommon before age 30 years (10). Based on available evidence, the College, the American Cancer Society (ACS), and the National Comprehensive Cancer Network recommend that clinical breast examination be performed annually in women aged 40 years and older.
Although the value of a screening clinical breast examination for women with a low prevalence of breast cancer (eg, women aged 20–39 years) is not clear, the College, ACS, and the National Comprehensive Cancer Network continue to recommend clinical breast examination for these women every 1–3 years (11). All three organizations also recommend the teaching of breast self-awareness and inquiry into medical history and family history of risk factors for breast disease.
How Often Should I Have a Clinical Breast Exam?
You should have a clinical breast exam every one to three years starting at age 20 and every year starting at age 40. A clinical breast exam may be recommended more frequently if you have a strong family history of breast cancer.
We understand the clinical breast exam can be very uncomfortable, however it is a preventive measure that might give peace to your mind. Besides it is only performed every 1 to 3 years. We included here two descriptions about how the clinical breast exam is performed so you have that information before going to your appointment.
What Happens During a Breast Exam?
Before your breast exam, your health care provider will ask you detailed questions about your health history, including your menstrual and pregnancy history. Questions might include what age you started menstruating, if you have children, and how old you were when your first child was born.
A thorough breast exam will be performed. For the exam, you undress from the waist up. Your health care provider will look at your breasts for changes in size, shape, or symmetry. Your provider may ask you to lift your arms over your head, put your hands on your hips or lean forward. He or she will examine your breasts for any skin changes including rashes, dimpling, or redness. This is a good time to learn how to do a breast self-exam if you don’t already know how.
As you lay on your back with your arms behind your head, your health care provider will examine your breasts with the pads of the fingers to detect lumps or other changes. The area under both arms will also be examined.
Your health care provider will gently press around your nipple to check for any discharge. If there is discharge, a sample may be collected for examination under a microscope.
Ages 19–39 Years: Exams and Screening Tests.
The following exams and screening tests are recommended for women in this age group: (please check page attached or follow the link below as we were unable to paste in this document the table that indicates the examinations recommended during the annual exam, including breast exam for women over 20 years old).
Clinical Breast Exam
The skin covering your breasts is checked for any rash, dimpling, or other abnormal signs. Your nipples may be checked to see if fluid is expressed when lightly squeezed.
The Value of Clinical Breast Exams
Clinical Breast exams are an important part of early detection. Although most lumps are discovered through breast self-exams, an experienced professional may notice a suspicious place that fails to register as a warning in the patient’s mind.
If you have any questions about it do not hesitate to ask questions during your next appointment.