What is the ACR recommendation regarding breast self-exam (BSE) and clinical breast exam (CBE)?

The ACR (American College of Radiology) currently does not recommend routine breast self-exams (BSE) or clinical breast exams (CBE) for breast cancer screening in average-risk women. This recommendation is based on evidence suggesting that these exams do not significantly reduce breast cancer mortality rates and may lead to unnecessary biopsies and anxiety among patients due to false positives and over-diagnosis.

The stance on breast self-exams, in particular, is that while women can perform BSE if they choose, it should not be relied upon as a primary screening method. Instead, the emphasis is placed on more effective screening methods such as mammography, especially for women starting at 40 years of age or younger if they are at high risk.

In regard to clinical breast exams, although these may be performed in a clinical setting, they are not a substitute for mammography and are not considered a requirement for breast cancer screening protocols by the ACR. This reflects a broader shift towards evidence-based practices where the focus is on methods that have proven efficacy in early detection and saving lives.

Consequently, the appropriate measure reflected in the recommendation is that breast self-exams and clinical breast exams are not recommended for any age group in the context of routine