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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: We agree with Dr Barton and colleagues¹ that there are few data to evaluate the clinical breast examination (CBE) as a clinical test. However, we believe the likelihood ratio (LR) they estimate for the presence of a mass in the breast is at least an order of magnitude too low.

The Health Insurance Plan of New York (HIP)² data, which the authors cite as the reference for Table 6 in their article, is a report of results of 449 biopsies of screen-detected breast masses.³ In the HIP study, 20% of masses were malignant and, as Mushlin⁴ pointed out, none of the clinical characteristics of a mass, once a mass was identified, were sufficient to lower the probability of malignancy to below 10%. Since posterior probability=prior probability x LR, then it is also true that LR=posterior probability/prior probability; in this case, LR=20/0.35=57 for the presence of a mass.

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