Some Experts No Longer Suggest Breast Self-Exams
Reported January 16, 2009
For decades, doctors and advocacy groups have urged women to examine their breasts every month for unusual lumps.
Now many of those same experts have a different message: Never mind.
Earlier this month, Danish researchers published the latest report to cast doubt on the value of monthly exams. In studies of nearly 400,000 women, they found that even diligent self-examinations don’t save lives. In fact, they may do more harm than good by triggering a lot of unnecessary follow-up tests.
For years, it was believed that self-exams could find breast cancer in its earliest stages, when it’s most treatable.
But doubts have been growing since 2002, when a huge study in China found that women who checked their breasts monthly were no less likely to die of breast cancer than other women, in spite of intense coaching in how to do the exams properly.
Scientists this summer took a fresh look at the growing body of evidence, including a huge group in Russia. Once again, they found no sign that self-exams cut the death rate. Instead, the women who examined their own breasts found more harmless lumps and had twice as many unnecessary biopsies as other women, according to a July 15 report published by the Cochrane Library. The conclusion: Self-exams “cannot be recommended.”
But more and more, doctors are walking a fine line.
“In general … we recommend it as just one more way to find an early breast cancer, but it has shown to be the least important way,” said Dr. Beverly Trombley, a radiologist who specializes in breast imaging at Abbott Northwestern Hospital’s Piper Breast Center. Mammograms, she said, are “by far the most important.”
Along with mammograms, experts now emphasize what they call “breast health awareness.” Essentially, that means being aware of changes in the breast, without necessarily going on a monthly scavenger hunt. If a woman finds something amiss, say, during a routine shower, she should notify her doctor and check it.