EDITORIALS Routinely Teaching Breast Self-Examination is Dead. What Does This Mean?

Physical examination of the breast is not a single test. Among clinicians (where it is termed “clinical breast examination ” or CBE), it has various degrees of accuracy, depending on the clinician and his or her technique (1). Among women (where it is termed “breast self-exam ” or BSE), it is sometimes an accu-rate test, but often it is not (2,3). In either case, physical exami-nation of the breast is a difficult examination to learn to do well, especially when searching for the subtle changes that can signal early breast cancer (2,4–9). Physical examination of the breast is a skill taught to the fingers; it is sometimes confused with the knowledge of the clinical significance of a lump in the breast. One can have little skill at detecting slight asymmetrical thickening in the breast yet understand that, should a breast lump be detected in the usual course of bathing or dressing (i.e., without a systematic