The diagnostic accuracy of breast medical tactile examiners (MTE) – A first prospective monocentric study
20 September 2018 (online)
Clinical breast examination (CBE) has been under discussion with regard to its usefulness in general and within breast cancer screening programmes. Aim of this study was to examine whether the addition of vision impaired medical tactile examiners (MTE) could improve the prediction of CBE with regard to suspicious breast lesions and to analyse the feasibility and acceptance in a diagnostic breast unit.
Material and methods:
This monocentric, prospective study included 104 patients without previous breast surgery. CBE was performed by physicians and MTE. The result of mammography and ultrasound were used as gold standard. Sensitivity and specificity were calculated. Furthermore logistic regression models were used.
Sensitivity was 71%, 82% and 89% for a CBE done by physician alone, MTE alone and physician and MTE combined, respectively. Respective specificities were 55%, 45% and 35%. Using adjusted logistic regression models the validated areas under the curves (AUCs) were 0.685, 0.692 and 0.710 [mean p value (DeLong)= 0.416].
CBE performed by MTE in patients without prior surgery had a similar predictive value for a suspicious breast lesion like a CBE performed by a physician. Perception of vision impaired MTE by patients was positive. Therefore the implementation of MTE in the clinical process of a CBE in a diagnostic breast unit seems feasible and could be an option to utilize the skills of this group of persons.