VALUE OF BREAST SELF-EXAM IN DOUBT

Results from the 10-year study of 266,000 female factory workers in Shanghai suggested that formal breast self-examination education programs ran a strong risk of diverting scarce resources and increasing the number of unneeded biopsies. Breast self-examinations can lull women into a false sense of security and are no substitute for regular mammograms and clinical exams.

Researchers set out to evaluate whether intensive brest self-examination training could reduce cancer deaths. The study, published in the Journal of the National Cancer Institute, found no evidence that such instruction saved any lives. The authors’ concluded that in poor countries, where women lack access to mammography, relying on training in breast self-exam would not seem to be a good use of the limited funds available for preventive services. Implications were less clear for women in countries like the U.S.: one danger is relying to heavily on self-exam, which might wrongly reassure women into thinking they need not bother to be examied by their doctors or get regular mammograms.

Despite the latest study, doctors say their basic advice remains unchanged They urge women to seek a professional’s advice if any new lumps or thickening of the breast tissue is found, as cancers typically respond much better to treatment when detected in the early stages. “We still recommend in our practice that women learn this skill as part of their overall wellness,” said Deborah Hamolsky, a registered nurse at the UCSF Carol Franc Buck Breast Care Center. “It’s still increasing wellness awareness. The way people stay healthy is by having a general awareness of what’s changing in their body, and know what to have checked out.”

The study concludes that a diligent practice of self-exam might enhance  the benefit of a screening program, even if there is no convincing evidence of any large-scale benefit from intensive education. It would take another large-scale study to determine the value of such an effort directed toward women in the U.S. In the meantime, the researchers urged women to take a realistic attitude and recognize the limits of today’s screening methods.