Articles Screening Clinical Breast Examination: How Often Does It Miss Lethal Breast Cancer?

receive screening clinical breast examination (CBE), little is known about CBE accuracy in community practice. We sought to estimate the rate of cancer detection (sensitivity) of screening CBE performed by community-based clini-cians on women who ultimately died of breast cancer, as well as to identify factors associated with accurate detec-tion. Subjects and Methods: We evaluated CBE accuracy among asymptomatic female health plan enrollees in fi ve states (WA, OR, CA, MA, and MN) who received a CBE within 1 year of breast cancer diagnosis and who died of breast cancer within 15 years of diagnosis (N = 485). Sensi-tivity was estimated as the proportion whose exam was abnormal. Bivariate and logistic regression analyses identi-fi ed patient characteristics associated with cancer detection. Results: An abnormality was noted on screening CBE in on