Gynecologie, Obstetrique, Fertilite & Senologie · Nov 5, 2026

Role of clinical breast examination in breast cancer screening strategies. Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF)

By Mathelin C, Taris N, Azuar AS et al.

France, like many countries around the world, is facing a rise in the incidence of breast cancer. Numerous studies have shown that the risk of death is linked to the initial stage of the tumor. In this context, mammographic screening for breast cancer aims to diagnose cancers at a subclinical stage, to limit treatment-related morbidity and reduce mortality. In France, this screening is recommended every two years for women aged 50 to 74, while clinical breast examination (CBE) by a healthcare professional is recommended by the Haute Autorité de Santé (HAS) starting at age 25, to be performed annually with no upper age limit. However, the practice of CBE needs to be updated, particularly regarding its impact on the number of cancers diagnosed, their stage, and mortality, considering new data from international literature. Design: The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method was used to assess the quality of the evidence on which these recommendations were based. Methods: The Senology Commission (SC) of the French College of Gynecologists and Obstetricians examined 16 questions regarding CBE, distinguishing four groups of women (the general population with or without mammography screening, women over 70 years of age, high or very-risk women, and women previously treated for breast cancer). For each scenario, it was determined whether performing a CBE, compared with not performing it, led to the detection of more breast cancers, reduced tumor size, or improved survival. One question addressed the training requirements for CBE. Results: The SC issued three recommendations aimed at: 1) recommending annual CBE for women in the general population aged 30 to 74, 2) recommending annual CBE for women who have previously been treated for breast cancer, 3) recommending that CBE be performed by a trained healthcare professional. The SC issued four position statements aimed at: 1) not advising CBE for women in the general population under the age of 30, as the procedure carries a risk of unnecessary follow-up tests in a group of women where the incidence of breast cancer is very low. 2) advising performing a CBE during breast cancer screening; 3) advising an annual CBE for women over 75 years of age, with the discontinuation of this practice depending on comorbidities and life expectancy. 4) advising annual CBE for women at high and very high-risk starting at age 20. According to the experts of the CNGOF’s Scientific Committee, a CBE should be performed only after obtaining explicit consent following the provision of information on its benefits and risks. The SC urges all women who notice a change or abnormality in their breasts to consult their doctor without delay to undergo a clinical breast exam.

doi.org/10.1016/j.gofs.2026.11.001PubMed 42988166Industry & policy