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Invited Critique |

Overall Clinical Breast Examination as a Factor in Delayed Diagnosis of Breast Cancer—Invited Critique

Seema A. Khan, MD
Arch Surg. 2002;137(10):1156. doi:10.1001/archsurg.137.10.1156.
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The standardization of the description of the breast physical examination has received little attention to date, particularly in the surgical literature. This study represents a welcome first step in this direction. The authors have coined the term durity for what appears to be the firmness of the breast to examination and have applied a relatively easily understood threshold for this. The categorical definitions for nodularity, on the other hand, are much more subjective. In an earlier study the authors reported concordance data on the assessment of breast nodularity,1 but 38.6% of women who were classified as having a nodularity grade of A or B at first examination in that study were thought to have a nodularity grade of C or D at a blinded second examination. It is not clear whether the same or a different observer performed the second examination, or what the average duration between examinations was.

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