New breast exam recommendations issued.

2004 DEC 2 - (NewsRx.com & NewsRx.net) -- A new report published by the American Cancer Society recommends training healthcare providers in a standardized version of clinical breast exam to find palpable cancers.

The Breast Health Education Program (BHEP) of the Oregon Health and Science University (OHSU) Cancer Institute is the only academic program in the U.S. that currently offers training matching this recommendation at all levels of medical education.

A committee of nationally recognized experts convened by the American Cancer Society in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) offers this and other recommendations in a report published in the November/December 2004 issue of CA: A Cancer Journal for Clinicians. The recommendations could help standardize the practice of clinical breast exam and lead to better evidence to show the effectiveness of clinical breast exam in the early detection of breast cancer.

"It is not possible to find breast cancer at its earliest stages the way most clinicians perform clinical breast exams," said Elizabeth Steiner, MD, associate director of the BHEP and research assistant professor of family medicine in the OHSU School of Medicine. "Breast cancer remains the most common cancer among American women and is the second leading cause of cancer deaths in women, yet most physicians report they have received little if any instruction on how to conduct a complete breast exam."

Clinical breast examination, or CBE, is an examination of the breasts by a healthcare professional to find palpable cancers early, when there are more treatment options and there may be a better chance for survival. Various methods of CBE are practiced widely. A 2003 study showed 90% of women 40 or older had received a CBE at some time, with about 75% having received one in the previous year.

The OHSU program was founded to provide medical students, residents, and practicing clinicians throughout Oregon with standardized CBE training that improves their ability to detect palpable cancer at its earliest stages. It is a collaboration involving many units of the School of Medicine, including the OHSU Cancer Institute, the Department of Public Health and Preventive Medicine, and the Department of Family Medicine in the OHSU School of Medicine. The CDC awarded $250,000 to Donald Austin, MD, director of the BHEP, associate director for cancer control and prevention in the OHSU Cancer Institute, and professor of public health and preventive medicine in the OHSU School of Medicine, in 2003 to support CBE training for medical students through the program.

The comprehensive training program stems from evidence-based research that reveals breast exams should include proper positioning of the patient, methodical thoroughness, a vertical-strip pattern as opposed to a circular or wedge technique, correct finger movements, three levels of pressure, and a comprehensive area of coverage.