Friday, July 17, 2009

The American Cancer Society (ACS) has done a very good job instructing women on the proper technique for BSE (breast self-exam). Are the doctors that

I'm part of a group in Maryland that travels around the state and teaches the "Mammocare" method to practicing physicians, usually primary-care physicians. That work is funded by the CDC (Centers for Disease Control) because Maryland has a very high breast cancer rate. I don't know what medical schools are doing about it, but in my breast center, we offer clinical breast exams performed by the radiologist, and it's a highly sought-after service.
I have patients who complain to me that their doctors do poor breast exams, and they don't know what to say or how to handle it. I think it may be important for you to say just before the exam starts that you really need the doctor to do a very careful exam, that it's very important to you, and that you are really depending on him or her to do this in conjunction with your own self-exam as well as mammography and other tests, as needed. Making this request may make a significant difference, but if the doctor does not respond in a way that is satisfactory to you, maybe you should find another doctor, or at least make sure there are enough other doctors on your team who are providing this important part of your examination.
At the very bottom of the breast, just above the crease or the fold, where an under wire would rest, the breast may have a very smooth or thick consistency, like the rind of a piece of fruit. It's thick and smooth and the edge of it can feel like a ridge. Don't expect our descriptions to fit your breasts exactly. Our only message here is that the breast tends to have different patterns of consistency, depending on the area. Get to know how your own breast tissue feels, and if you have any questions, bring them to the attention of your doctor.

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