Updated Nov. 6, 2008 – A report last week by a panel of experts suggested that breast self exams do not improve a woman’s survival. American experts, however, caution women not to give up the practice.
The controversial suggestion that breast self-examination and clinical breast examination by a trained practitioner do no good was based on a review of two large randomized controlled studies from China and Russia.
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The studies concluded that women assigned to do regular breast self-examinations were almost twice as likely to undergo a biopsy of the breast than women in the control group. They found no difference in the number of cancers diagnosed overall.
The new review is based on two studies that together included more than 388,500 women in Russia and China who ranged in age from 30-66.
Some of the women were trained to do breast self-exams. They also got regular reminders or refresher classes to make sure their technique was correct. For comparison, the other women in the studies weren't taught or urged to do breast self-exams.
The women were followed for 10 years. During that time, 587 women died of breast cancer, with similar numbers of deaths in the breast self-exam group (292 breast cancer deaths) and in the group of women who weren't trained to do breast self-exams (295 breast cancer deaths).
“We would like to inform women that there is no evidence from two large studies that screening by regular breast self-examination (once a month) improves their chances of surviving breast cancer, whereas there is evidence that regular breast self-examination almost doubles their risk to undergo a biopsy," reviewer Jan Peter Kosters, MD, of the Nordic Cochrane Centre, tells WebMD via email.
U.S. officials offer a different take on Breast self-exams
The review doesn't mean that breast self-exams haven't helped individual women. Good Morning America anchor Robin Roberts said in 2007 that she found the lump that turned out to be breast cancer during a breast self-exam, and many other women say that was the means by which they discovered their breast cancer.
However, what the report says is that in large groups of women, the numbers aren't there to show a benefit to women's survivalt, Kosters and his colleagues report.
Doing a breast self-exam is still "an option," Debbie Saslow, PhD, the American Cancer Society's director of breast and gynecologic cancer, tells WebMD. "We don't want to recommend against it but there's no evidence to recommend for it."
"Certainly, if any woman wants to do breast self-exam, then her doctor should give her assistance and make sure that her technique is what it should be, and also let her know what the limitations are...," Saslow says. Women should know that breast self-exams don't increase her chances of survival should she find a malignant lump, he added.
But the breast self-exam finding is "a wake-up call," says Susan Love, MD, president and medical director of the Dr. Susan Love Research Foundation. calls. 'We've been relying on things that don't work that well and we really have to start demanding something that works better.'"
Breast awareness is the key
To Saslow, the key message is to get medical attention for any breast lumps, whether those lumps are found during a breast self-exam or "in the shower or getting dressed or looking in the mirror or her husband [notices it]."
The review "doesn't say never touch your breasts again. It says that the normal poking around that we all do is enough, and that formal ... breast self-exam doesn't add to that," says Love, who calls the review "excellent."
Further, the experts stressed that, in light of these findings, it becomes even more critical for women to get mamograms, particularly if they are age 40 or older, or younger if they have someone in their families who have had breast cancer.
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