The approach to detecting breast carcinoma in gynecologic practices remains controversial. Fourty-five breast carcinomas were detected in 8757 patients, using a combination of physical examination, mammography, thermography, and fine-needle aspiration. The sensitivity of each modality is as follows: physical examination, 62.2%; mammography, 63.2%; thermography, 75.6%; and fine-needle aspiration biopsy, 93.7%. Review of the current literature reveals a lack of agreement concerning the indications and the recommended frequency of use of each type of examination. Because of inaccuracies in each technique, a muitimodal approach is indicated for the earliest detection of breast carcinoma.