A systematic review 1 was abstracted in DARE. No trial has compared clinical breast examination (CBE) with no screening. Mammography outperformed CBE in 3 out of 4 trials comparing sensitivities: the proportion of cancers detected by CBE alone ranged from 3.4% to 45%. On the basis of 3 RCTs and 3 non-randomised studies, the sensitivity of CBE is approximately 54% (95% CI 48 to 60) and according to 3 RCTs and 2 non-randomised studies the specificity is about 94% (95% CI 90 to 97). The pooled positive LR is 10.6 (95% CI 5.8 to 19.2; 3 RCTs and 1 non-randomised study), and the pooled negative LR is 0.47 (95% CI 0.40 to 0.56, 3 RCTs and 1 non-randomised study).
Comment: The quality of evidence is upgraded by large magnitude of effect. An overall view of the evidence suggests that carefully performed CBE detects cancers that are potentially curable.
Primary/Secondary Keywords