Entry 4: BONUS BLOG: Clinical Breast Exams

This week’s entry depicts a clinical breast exam (CBE). Clinical Breast Exams are basically THE way breast cancer is detected in women under 40 (as mammography is not recommended for this demographic). As I noted in a previous blog, studies are now showing that CBE’s may be equally effective in detecting breast cancer in women of all ages.

So, listen up, ladies! This is important!

A couple things to know about reality vs. vlog in this entry:

1) Breast exams are typically performed in exam rooms, not in offices. Accessing exam rooms to film in has been a challenge (although future vlogs have been filmed in exam rooms. Thanks IVF-New Jersey!). This was shot in a rehearsal studio near Lincoln Center. Lincoln Center is the home of the Metropolitan Opera. Halfway through filming a baritone starting rehearsing next door… this may be why opera music is playing in the background.

2) Most breast centers do not play opera music.

3) Yes fellas, breast centers are a real thing. They’re not as amusing as they sound. Sorry.

4) I have had a few clinical breast exams. Because of my family history, since I turned 18, I have had them performed by PCP’s and Gynos. These exams were usually performed sitting up on an exam table for a visual assessment, and then lying down for a physical examination. The nature of physical examination varies from person to person, but always involves palpating (ie feeling up) both breasts and the lymph nodes under each arm pit, generally using the pads of the fingers.

While it is not painful, the woman in this photo makes it look like a spa day. It's also not that.

In the vlog, our exam was performed standing up, because again, we weren’t filming in an exam room and had to work within the parameters of filming in a rehearsal studio. Real CBE’s aren’t performed this way. However, the section where The Navigator compared my breasts visually was very true to life. Yes, she did ask if my nipples have always been “different.” No, I will not tell you how they are different. A girl’s gotta have some secrets. Although, obviously I no longer have very many.

A few more important facts about CBE’s:

1) CBE’s can be performed by any medical personnel trained to do so.

My Primary Care Physician has performed them when I don’t have plans to see my gynecologist in the near future. My gynecologist has performed them on me (of course), but so have nurses and nurse practitioners. The Navigator was an MA, RN. I think she did a great thorough job—absolutely as good a job as any doctor I’ve had.

Something I don’t talk about in the vlog is that I had a CBE performed in May by my gyno, and she didn’t feel any abnormality. Probably the cancer was too small to detect through a CBE, but I will say I felt her CBE was less thorough than the one performed by The Navigator.

My point is, it doesn’t matter who performs a CBE (doctor, nurse etc.) as long as they are good.

2) ACS recommends women start having CBE’s at age 20, at least every three years.

I recommend having them every time you go to a Primary Care Physician or Gynecologist for a check-up, because, why not? If you go annually like you’re supposed to, that’s once or twice a year—it takes five minutes, why not do it?

Actually… there is a risk. Studies show that after ten years of CBE’s, the rate of “false positives,” is about 20 percent. This means 20% of the time a doctor feels something “off” and sends a patient for follow-up tests, it turns out to be nothing. These tests can be painful (as my next three vlogs will indicate), and cause emotional distress.

That said, the pain and emotional distress of diagnostic tests is small when compared to the pain and emotional distress of a cancer that went undetected for a long time. So, my vote is err on the side of caution and have your doctor touch your boobs.

3) Ask your doctor about your breasts when you have them examined.

Have your doctor describe your healthy breasts to you. This is not a pre-cursor to asking your doctor on a date. I promise.

I wish I had known my breasts better before having cancer. I think if I had really thought more about what my breasts felt like, I may have detected my cancer sooner. I know I have always had dense breast tissue (which makes cancer harder to detect), and doctors told me that. But, looking back, I wish I had other descriptors. I feel if I had had words to describe my healthy breasts, I would have realized sooner that I was using new words to describe my breasts with cancer.

That said…

4) Breasts change: over time due to age; month to month due to periods; babies, menopause… all these things cause breasts to change.

I will talk more about this in another blog about self-breast exams. But, because breasts do change try to schedule breast exams at the same point in your cycle, ideally just after you finish menstruating (this is when your breasts will be least sensitive to a doctor prodding you).

So, that’s it! Clinical Breast Exams are easy, and potentially life-saving. Do them, your girls will thank you (and so will the rest of your body!).

It will be two weeks until the next vlog, but expect a few extra blogs in the interim. More on that here.

More on Clinical Breast Exams can be found lots of places (just ask Google), but I especially liked Susan G. Komen’s Info Page.

#clinicalbreastexam #mammogram #resources #tips

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