Physical examination of the breasts in screening for breast cancer.

No currently available evidence from breast cancer screening studies provides strong justification for the implementation of screening in elderly females. Because it is an absence of evidence rather than negative evidence which pertains, it is concluded that if screening is introduced it should include both mammography and clinical examination of the breasts because the two complement one another. As well, stringent quality control procedures are required for both modalities. It is possible that clinical examination of the breasts performed by a nurse-examiner will enhance compliance with screening schedules.