Georgia DPH Deploys New Breast Exam Training Technology to Improve Accuracy

First in Nation to Upgrade Breast Exam Standards

Women in Georgia will benefit from the breast exam training program developed by MammaCare scientists with the support of the National Science Foundation. The team of scientists identified the specific breast exam skills required for early detection of small suspicious tumors while reducing false positives. They produced a hands-on, computer-guided simulator technology that validates the performance of these critical skills. In cooperation with the Georgia Department of Public Health Breast and Cervical Cancer Program (BCCP), the MammaCare system will train nurses in each of Georgia’s 159 counties. The training technology is in use by the Women Veterans Health Program and by US colleges of nursing and medicine. Georgia’s DPH is the first BCCP to deploy the training system statewide.

Although nurses and physicians routinely examine women’s breasts for suspicious lesions or tumors, performance and results vary widely. Mary Ann Mehn, Ph.D., MammaCare’s Director of Education, said that Georgia DPH staff public health nurses are now being trained and certified to deploy the system throughout Georgia’s BCCP. Mark Kane Goldstein, Ph.D., MammaCare Senior Scientist explained: “The MammaCare Clinical Breast Exam Simulator-Trainer standardizes critical performance skills with a series of “intelligent” breast models that measure exam accuracy and provide corrective feedback in real time.” “If performance on any one of the breast exam modules does not meet built-in standards of sensitivity, specificity, and thoroughness, the program requires the user to repeat the module before moving on to the next one,” Goldstein added.

MammaCare, the recognized standard for clinical and personal breast exams, began in 1974 as a National Cancer Institute project to determine the smallest palpable breast tumor that is reliably detectable by hand. MammaCare training technology and certification courses are available at

The MammaCare Clinical Breast Exam Simulator-Trainer standardizes critical performance skills with a series of ‘intelligent’ breast models that measure exam accuracy and provide corrective feedback in real time.


Mary Ann Mehn, Ph.D.,

Mark Kane Goldstein, Ph.D.

Cell: 352.256.4573

Office: 352.375.0607

CBE Simulator-Trainer Video

Revolutionary Technology Improves Accuracy of Clinical Breast Examinations


Revolutionary Technology Improves Accuracy of Clinical Breast Examinations
MammaCare® Breast Exam Simulator Produces Smart Fingers™

GAINESVILLE, Fla.,  (GLOBE NEWSWIRE) – MammaCare, recognized for advancing breast examination standards announced a revolutionary, computer-guided clinical breast examination (CBE) technology that improves and objectively confirms practitioners' ability to reliably detect small breast tumors while reducing false positives. MammaCare scientists developed a series of tactually accurate breast models containing small, simulated breast cancers from 3mm, the size of a small pea to 7 mm  the standard range for measuring breast examination proficiency.

"The challenge was to find a way to link the models to an intelligent device that could accurately translate the examiner's subjective, tactual sensations into digital code."  Mark Kane Goldstein, Ph.D, a team scientist exaplained.  The National Science Foundation (NSF) supported this effort leading to an engineering breakthrough that digitally replicates and displays the sensations fingers experience while palpating breast tissue and detecting tumors. A novel laptop controlled interface guides trainees palpating fingers through exercises on a series of breast models until they are able to find the tiny simulated tumors without falsely "detecting" non-existent ones. They must successfully perform the requirements of each learning task before the simulator's program will present the succeeding ones.

Initial trials of the simulator at Mayo Clinic found significant gains in sensitivity (finding tumors that are present) and specificity (not finding tumors that are absent). The MammaCare and Mayo Clinic teams presented the first research report at an international breast cancer congress in July. At the request of the VA's Women Veterans Health Care Program MammaCare dedicated the first three months production of the simulator to optimize breast examination practices for VA medical and nursing staff who provide healthcare for nearly two million women veterans.

Dr. HS Pennypacker, a pioneer in developing instructional technologies, designed the training software that incrementally shapes each component of breast examination and detection skill required to meet proficiency standards. A co-founder of MammaCare, Pennypacker said, "If we can teach fingers to read Braille dots, we can surely teach fingers to find suspicious lesions in breast tissue."

After observing the Simulator improve breast examination performance at the Women Veterans Health Program Medical Centers, Dr. Mary Mehn, MammaCare's Director of Education named it; "Smart Fingers". She noted, "Breast cancer screening depends on the quality of manual examinations and mammograms. Both must be performed skillfully. We finally have the method to reach and teach every hand that examines women."

The MammaCare breast exam training technology was supported in part by the National Science Foundation.