The third component of a good breast health program is a clinical breast examination (CBE) executed by a physician or other trained health care professional, typically the day your receive a mammogram, or every three years between the ages of 20 to 39. Since mammography misses approximately 15 percent of all cancer lumps, CBE plays an integral role in the program.

After taking a medical history, your health care professional should begin the examination by asking you to sit up on the examination table (the examination sequence that follows may vary slightly). Just as you did with BSE, she will be looking for evidence of puckering, dimpling, discoloration, nipple discharge or an inverted nipple (for a small percentage of women inverted nipples are the norm), or any other irregularities that suggest a possible problem. The areas above and below the collarbone and in the underarm areas are examined for lymph node enlargement, which can denote either an infection or a cancer that has traveled from the breast area. Palpation of each breast follows — this allows the health care provider to search for detectable masses. She should then ask you to raise your arms and press your palms together in front of your chest to contract the chest muscles allowing an abnormality to stand out. Finally, lying down with one arm raised overhead, your breast on the same side as the raised arm should be thoroughly examined with the procedure repeated on the other side.

If you feel your health care provider has given your breasts only a cursory exam, it’s perfectly okay to let her know. For example, if your breasts and underarms were only examined while you were sitting up, you can suggest it be repeated while you’re lying down on the exam table. It might even lead to inclusion of the reclining position into future CBE examinations of all patients.

When you participate in a complete breast health program rest assured that you are taking giant steps toward protecting your health.

* A Complete Breast Health Program is adapted from
Reduce Your Breast Cancer Risks: Basic Facts Plus Four Simple Changes That Work by Joyce C. Smolkin