Why is a clinical breast exam (CBE) no longer recommended?

Clinical breast examination (CBE) is a physical exam done by a health professional. During the beginning of the mammography era, the combination of CBE and mammography was associated with a lower risk of dying from breast cancer, and CBE was shown to offer an independent contribution to breast cancer detection. Since then, as mammography has improved and women’s awareness and response to breast symptoms has increased, the few studies that exist suggest that CBE contributes very little to early breast cancer detection in settings where mammography screening is available and awareness is high.

In addition, there was moderate evidence that doing CBE along with mammography increases the rate of false positives. Based on this information, the current guideline does not recommend CBE for US women at any age.  

There are settings in the US where access to mammography remains a challenge, and the American Cancer Society will continue to work to ensure that all women have access to mammography screening. We recognize that some health care providers will continue to offer their patients CBE, and there may be instances when a patient decides with their health care provider to have the exam- and that's OK. The important message of our guideline is that CBE should not be considered an acceptable alternative to mammography screening, no matter the challenges of access to mammography.