CLINICAL BREAST EXAMINATION;

THE DIAGNOSTIC ACCURACY IN PALPABLE BREAST LUMPS

Abstract

Objective: To determine sensitivity and specificity of standardized clinical breast examination (CBE) for benign and malignant breast lumps. Design: A prospective validation study. Place & duration of study: The study was conducted at Railway hospital, Rawalpindi from September 2008 to February 2010. Patients & Methods: A total of 110 female patients presenting with breast lumps were recruited in the study. All of them underwent a standardized clinical breast examination along with complete triple assessment. The sensitivity and specificity of CBE was calculated and compared with that of triple assessment in the same patient. Likelihood ratios for individual characteristics of breast lumps were also calculated. Results: Sensitivity of a structured CBE to pick up carcinoma breast in a patient with lump breast was 100% (95% CI, 0.8-1) while specificity was 94.6% (95% CI, 0.86-0.97). The likelihood ratio for carcinoma breast was 17.8 (95% CI, 7.6 - 41.7). Conclusions: The standardized CBE can differentiate between palpable benign and malignant lumps reliably. This is especially important in benign lumps where a policy of follow up clinical examination can be utilized, particularly when the investigative facilities may not be readily available.