Connect
MJA
MJA

Is it time to abandon clinical breast examination?

Belinda E Kiely and Annabel Goodwin
Med J Aust 2021; 215 (10): . || doi: 10.5694/mja2.51285
Published online: 15 November 2021

Despite limits to its clinical value, the potential benefits for women should not be overlooked

Women with mutations in breast cancer predisposition genes have a very high risk of developing breast cancer and are offered risk‐reducing strategies and intensified surveillance; many are referred to specialist risk management clinics. Because magnetic resonance imaging (MRI) is more sensitive for detecting breast cancer at an early stage than mammography,1 it is part of most high risk breast cancer screening programs, and in Australia is covered by Medicare for women at high risk under 50 years of age.2


  • 1 NHMRC Clinical Trials Centre, the University of Sydney, Sydney, NSW
  • 2 Concord Repatriation General Hospital, Sydney, NSW


Correspondence: belinda.kiely@sydney.edu.au

Competing interests:

Belinda Kiely has received honoraria from Roche for sitting on an advisory board (2018, 2019), and Annabel Goodwin has received honoraria from AstraZeneca and Pfizer for sitting on advisory boards (2018, 2019).

  • 1. Warner E, Messersmith H, Causer P, et al. Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer. Ann Intern Med 2008; 148: 671–679.
  • 2. Australian Department of Health. Medicare Benefits Schedule: item 63464. MBS Online. http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=63464&qt=item&criteria=breast%20MRI (viewed Sept 2021).
  • 3. Hettipathirana T, Macdonald C, Xie J, et al. The value of clinical breast examination in a breast cancer surveillance program for women with germline BRCA1 or BRCA2 mutations. Med J Aust 2021; 215: 460–464.
  • 4. Runowicz CD, Leach CR, Henry NL, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol 2016; 34: 611–635.
  • 5. Ngan TT, Nguyen NTQ, Van Minh H, et al. Effectiveness of clinical breast examination as a ‘‘stand‐alone’’ screening modality: an overview of systematic reviews. BMC Cancer 2020; 20: 1070.
  • 6. Mittra I, Mishra GA, Dikshit RP, et al. Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai. BMJ 2021; 372: n256.
  • 7. Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: an update for the US Preventive Services Task Force. Ann Intern Med 2009; 151: 727–737.
  • 8. Rijnsburger AJ, Obdeijn IM, Kaas R, et al. BRCA1‐associated breast cancers present differently from BRCA2‐associated and familial cases: long‐term follow‐up of the Dutch MRISC Screening Study. J Clin Oncol 2010; 28: 5265–5273.
  • 9. MARIBS Study Group. Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 2005; 365: 1769–1778.
  • 10. Guindalini RSC, Zheng Y, Abe H, et al. Intensive surveillance with biannual dynamic contrast‐enhanced magnetic resonance imaging downstages breast cancer in BRCA1 mutation carriers. Clin Cancer Res 2019; 25: 1786–1794.
  • 11. Spiegel TN, Hill KA, Warner E. The attitudes of women with BRCA1 and BRCA2 mutations toward clinical breast examinations and breast self‐examinations. J Womens Health (Larchmt) 2009; 18: 1019–1024.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.