breast and pelvic examination in women taking HRT

Last reviewed 01/2018

The advice from the Committee on the Safety of Medicines (CSM)'s on clinical breast and pelvic examination is that (1):

• it is not routinely necessary in all women taking hormone replacement therapy (HRT)
• it should only be performed if clinically indicated

Also the CSM advises:

• breast screening with mammography has higher sensitivity and specificity than clinical breast examination
• women should be encouraged to participate in the national breast cancer screening programme, which invites all women age 50-64 for mammography every 3 years (women over 64 are eligible for free 3-yearly screening on request)
• breast awareness should be encouraged, as most breast cancers that are not found on mammography are found by women themselves
• women should also be encouraged to participate in the national cervical screening programme which invites women aged 25-64

The advice is consistent with earlier advice from the Chief Medical Officer (CMO) that clinical examination of the breast by a health professional is not routinely necessary in well women (2).

Reference:

• (1) Department of Health (October 2001). CMO's Update, 8.
• (2) Department of Health. Clinical examination of the breast. Department of Health. February 1998; Professional Letter: PL/CMO (98) 1, PL/CNO (98), 1.