Does your doctor (either primary care physician or gynecologist) do a quality clinical breast exam (CBE)? Is he/she spending adequate time examining you, or are you just receiving more of a drive-by CBE?

I hear from more and more women that either their doctor simply isn't examining their breasts anymore unless the patient reports having a symptom, or that the exam is so brief they blinked and it was over.

Here's another alarming trend I'll share with you: Very little time is spent in medical schools teaching residents and medical students how to do this important clinical assessment. (Sometime, I'll have to inquire around about how much time is devoted to testicular exams. Are the men also getting short-changed? Hmmm.)

My personal experience is that the best CBEs I've received usually have been done by a nurse practitioner. The NP is thorough, she covers all the breast tissue (which goes over to my armpit and up to my clavicle), and she asks me questions as she performs it. Then she asks me to demonstrate to her how I do a self-exam, so she can find out if I'm following the correct technique. (Watch this video: How to Perform a Breast Self-Exam.)

Remember, too, that when you come in for your exam, it's probably been a year since you last saw your doctor. In the meantime, he/she has had their hands on a zillion other women's breasts in the exam room. So make sure the doctor checks back in your medical record documentation for any abnormal findings that warrant follow-up now.

You should always try to get your clinical breast exam close to when you get your mammogram, too (especially those who are age 40 and above). This way, if something is felt it can be examined more closely when either the CBE or the mammogram is done. If something is seen on imaging, it can be carefully assessed when doing the hands-on exam.

If you get the impression that your internist figures your GYN is doing the CBE, and your GYN figures your internist has it covered, speak up! I'd much prefer they both be checking me than no one. And be sure to also be checking yourself each month.