MammaCare’s mission is to train every hand that examines a woman, including her own.

MammaCare, the recognized quality-standard for physical examination of the breast, was developed with the support of the National Cancer Institute, the National Science Foundation and medical scientists worldwide.

The contributions of MammaCare scientists and colleagues have been noted in landmark reports on early detection…

Does This Patient Have Breast Cancer? The Screening Clinical Breast Examination: Should It Be Done? How?  Journal of the American Medical Association, 1999 Oct, 6: 283(13), 1687-9.  Barton, M.B., Harris, R. & Fletcher, S.W.

“Our recommendation incorporates practices from the MammaCare method because its components have been validated in independent investigations of CBE technique.” (p. 1276)

How best to teach women breast self-examination. A randomized controlled trial.  Annals Intern Med. 1990 May 15;112(10):772-9. Fletcher SW, O’Malley MS, Earp JL, Morgan TM, Lin S, Degnan D.

Mammacare instruction resulted in more long-term improved lump detection and examination technique use than did traditional instruction or physician encouragement. Breast self-examination instruction should emphasize lump detection skills.


Updated October 2019

Recent reports confirm that a substantial portion of breast cancer is detected by clinicians’ or  womens’ fingers.

Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Cancer Epidemiol. 2017 Jun;48:140-146. doi: 10.1016/j.canep.2017.04.010. Epub 2017 May 23.

A total of 56 presenting symptoms were described: breast lump was the most frequent (83%)…

Clinical Value of Mammography in the Evaluation of Palpable Breast Lumps in Women 30 Years Old and Older. American Journal of Roentgenology. 2017;209: 935-942. 10.2214/AJR.16.17088

…palpable breast lumps have a higher probability of breast cancer than all patients who undergo diagnostic breast imaging.

New Palpable Breast Lump With Recent Negative Mammogram: Is Repeat Mammography Necessary?. American Journal of Roentgenology. 2016;207: 200-204. 10.2214/AJR.15.14799

A woman may present with a new palpable lump after having had a recent negative mammogram…

Twenty-five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014 Feb 11;348:g366. doi: 10.1136/bmj.g366. Miller, A. B., Wall, C., Baines, C. J., Sun, P., To, T., & Narod, S. A.

Upon finding that most cancers were palpable at mammography screening visits, Miller et; al. concluded: “From this we infer that if there is benefit from a mammography only screening programme, it is derived through cancers detectable by a thorough breast physical examination.”

A significant number of women present with palpable breast cancer even with a normal mammogram within 1 year. Am J. Surg 2010 Dec; 200(6): 712-7. Haakinson DJ, Stucky CC, Dueck AC, Gray RJ, Wasif N, Apsey HA, Pockaj B.

Patients presenting with palpable masses on SBE or CBE even with a normal mammogram within 1 year tended to have more aggressive tumors… resulting in more aggressive therapy.

Breast cancer presentation and diagnostic delays in young women. Cancer. 2014 Jan 1;120(1):20-5. doi: 10.1002/cncr.28287. Nov 11. 2014 Ruddy KJ, Gelber S, Tamimi RM, Schapira L, Come SE, Meyer ME, Winer EP, Partridge AH.

Most young women detect their own breast cancers…

Palpable presentation of breast cancer persists in the era of screening mammography. J Am Coll Surg. 2010 Mar; 210(3): 314-8. Mathis KL, Hoskin TL, Boughey JC, Crownhart BS, Brandt KR, Vachon CM, Grant CS, Degnim AAC.

Patients with palpable presentation were younger than those with screen-detected cancer (mean age 57 versus 62 years…).

Discovery of breast cancers within 1 year of a normal screening mammogram: how are they found? Ann Fam Med. 2006 Nov-Dec; 4(6): 512-8. Carney PA, Steiner E, Goodrich ME, Dietrich AJ, Kasales CJ, Weiss JE, MacKenzie, T.

Having a lump and both a personal and a family history of breast cancer was the most common reason why women initiated a health care visit.

Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women. J Womens Health. 2011 Aug; 20(8): 1135-9. Roth MY, Elmore JG, Yi-Frazier JP, Reisch LM, Oster NV, Miglioretti DL.

Most women survivors (57%) reported a detection method other than mammographic examination.

Measuring performance in clinical breast examination. Br J Surg. 2010 Aug;97(8):1246-52. Wishart GC, Warwick J, Pitsinis V, Duffy S, Britton, PD.

performance measures…could help to identify clinicians who have a lower sensitivity for CBE and who may therefore require feedback and further training.

Tumor Characteristics Associated With Mammographic Detection of Breast Cancer in the Ontario Breast Screening Program. J Natl Cancer Inst 2011. Jun 22;103(12):942-50. Epub 2011 May 3 Kirsh VA, Chiarelli AM, Edwards SA, O’Malley FP, Shumak RS, Yaffe MJ, Boyd, NF.

…77% of these were true interval cancers, detected clinically in the 1–2 year interval between screening examinations…

Surveillance of women at increased risk of breast cancer using mammography and clinical breast examination: Further evidence of benefit. Int J Cancer. July 2012  ;131(2): 417-25. Andrew Maurice, D. Gareth Evans, Jenny Affen, Rosemary Greenhalgh, Stephen W. Duffy, Anthony Howell

We reviewed its effectiveness in terms of tumour size, lymph node status and survival in 7,475 women seen over a 22-year period in the Manchester Family History Clinic. …. We conclude that screening by annual mammography and CBE between age 35–50 years and 18 monthly from 50 to 60 years may diagnose breast cancer in a less advanced state in terms of size and node status.

Excessive resections in breast-conserving surgery: a retrospective multicentre study. Breast J. 2011 Nov-Dec; 17(6): 602-9. Krekel N, Zonderhuis B, Muller S, Bril H, van Slooten HJ, de Lange de Klerk E, van den Tol P, Meijer S.

Of all tumors, 72% (525/726) were palpable, and 28% (201/726) were nonpalpable. The tumor stage was T1 in 492 patients (67.8%) and T2 in 234 patients (32.2%).

Improved Clinical Breast Examination Competencies Via Intelligent Simulator Training, July 7, 2012   Meeting of the German Society for Senologie, Stuttgart Goldstein M.K.*, Mehn M.A.*, Pennypacker H.S.*, Brost B.C.** Petersen W.O.**, Nicometo A.M.**,  MammaCare* and Mayo Clinic**

Two independent trials found that the CBE Simulator produced significant gains in clinical breast examination skills suggesting that this technology may improve the accuracy and quality of breast cancer screening.

For a review of studies about MammaCare, Google Scholar is useful.

A research bibliography is also available on this website.