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Most guidelines for periodic screening recommend an annual clinical breast exam (CBE). However, it is unclear how effective a screening tool this exam is. Pooling data from controlled trials and case-control studies in which CBE was at least part of the screening modality, these authors studied the effectiveness of CBE in detecting breast cancer.
CBE alone detected 3% to 45% of breast cancers that screening mammography missed. CBE sensitivity and specificity were estimated at 54% and 94%, respectively. In studies that compared the sensitivity of CBE with that of mammography, most data showed that mammography was more sensitive than CBE, but the sensitivity of both methods together was superior to either alone. Breast lump detection was impro…