Honoring Breast Cancer Awareness Month Through Physical Exam Knowledge

October 16, 2023 – by Lindsay Paulsen, Media Logic

When October arrives with its bright orange and red foliage, it also often brings a flurry of pink ribbons, signaling that it’s also Breast Cancer Awareness Month! Each fall, this observance aims to promote education about the disease that impacts roughly one in eight women. 

In this blog post, we’ve outlined useful information and key resources to help physicians identify signs of breast cancer and other abnormalities at the patient bedside.

According to the National Breast Cancer Foundation (NBCF), breast cancer is the most common form of cancer (apart from skin cancer) in American women. About 13 percent of women in the United States will develop breast cancer in their lifetime and NBCF estimates that the disease will comprise approximately 30 percent of all new female cancer diagnoses.

Following are some additional breast cancer facts from NBCF:

• About 15% of women who are diagnosed with breast cancer have a family history of the disease.
• Women who have a first-degree relative, such as a mother, sister or daughter with breast cancer are twice as likely to develop breast cancer.
• Although the average age of women who are diagnosed with breast cancer is 62 years, about 9% of new breast cancer cases are diagnosed in women who are younger than 45.
• Breast cancer impacts women of every race and ethnicity, but different groups experience different outcomes. For example:
  • Black women are 40% more likely to die from breast cancer than white women.
  • Hispanic women are more likely than white women to be diagnosed with breast cancer at a later stage, which often means it is more advanced and more difficult to treat.
• Men can also develop breast cancer. About 2800 men will be diagnosed with invasive breast cancer this year.

Fortunately, thanks to numerous scientific advancements and an emphasis on early detection, breast cancer rates are falling: From 1989 to 2020, breast cancer death rates decreased by 43%, and there are currently over 3.8 million breast cancer survivors in the U.S. The American Cancer Society also indicates that the 5-year relative survival rate for cancer diagnosed at the localized stage is 99%.

As early detection improves outcomes in breast cancer, thorough physical exams are one of the first lines of defense.

When performing a breast exam, keep these general tips in mind:

• We advise male examiners to have a female chaperone present during the exam.
• Always wash your hands before and after a breast exam.
• We believe it is better not to wear gloves while palpating the breasts. Wearing gloves may reduce your ability to fully appreciate all the features of a lesion, especially small ones!
• The timing of the exam relative to your patient’s menstrual cycle is important.
• The best moment to perform a breast exam is right after the end of menstruation when benign lesions are smaller and less tender.
• The worst moment to perform a breast exam is right before the beginning of menstruation when the most common benign lesions are more painful and bigger. This can make it difficult to differentiate between normal and malignant masses.

Take a deeper look at some of Stanford Medicine 25’s resources on the breast exam:

• See our outline of the breast exam here. This guide details key abnormalities, inspection maneuvers and advice for patient positioning.
• Follow along with a video demonstration of the breast exam here.
• Explore our approach to the related lymph node exam.