Are Breast Self-Exams
More Harm Than Good?

(HealthScoutNews) -- A review involving nearly 500,000 women contends that there's no difference in dying from breast cancer between women who examine their own breasts and those who don't. Further, it says, going through the routine could cause you harm.

The startling finding is raising more than a few eyebrows in the American medical establishment.

"The rate of breast cancer is going down -- and women themselves have played a great role in this, and breast exams are a part of it," says Dr. Bonnie Reichman, associate professor of clinical medicine at Weill-Cornell Medical College.

The new study has prompted the Canadian Task Force on Preventive Health to recommend that breast self-exams not be routinely taught to women aged 40-69, the researchers say. They concluded that the exams are ultimately harmful because they raise the number of needless biopsies.

It is a recommendation, however, that at least some American doctors feel does not do women justice.

"I think any woman in America -- or for that matter anywhere in the world -- would rather put up with a unnecessary biopsy than give up her opportunity to catch a breast cancer early and in the process save her own life," says Reichman, who was not part of the study. "To say breast exams don't help is doing a terrible dis-service to women."

Still, according to the new research, there is little to show that the exams help.

"We found that there was no difference in mortality from breast cancer between groups that were assigned to do breast self-exams, or groups not assigned to breast self exams -- but we did find that there was a significant number of physician visits for benign breast problems, and a significant number of benign breast biopsies," says Dr. Nancy Baxter, the principal investigator of the study, who, at the time of the research was a general surgeon at University of Toronto Medical School.

The problem, as Baxter sees it, is not so much that the exams don't work -- but that they are seldom done correctly. Further, she contends that doing the exam inadequately is worse than not doing one at all, particularly in regard to creating a false sense of security.

Reichman raises an emphatic objection.

"If studies show that when done correctly, breast self-exams do work, then why are we telling women not to do them? What we should be saying is, talk to your doctor and find out how to do the exam correctly -- that's the message that makes the most sense, and will do women the most good," says Reichman.

The study, published in tomorrow's issue of the Canadian Medical Association Journal, was what doctors term a "systematic review" -- a look at studies already published in hopes of organizing the findings into a public health guideline.

In this instance, the researchers focused on seven studies of women who performed breast self-exams. This group included a large Chinese trial of some 266,000 women, a Russian study of more than 122,000 women, British research on nearly 82,000 women, and several smaller studies including one from Canada.

In each of the studies, the women were divided into two groups -- one of which regularly performed breast self-exams, and the other that did not do the exams. The final analysis looked at breast cancer mortality rates among the two groups.

"There was, in fact, no significant difference between the women who did the self breast exams and those who did not," says Baxter.

Even in the confines of a medical teaching program, where women would be expected to perform the self-exams better than the average woman, Baxter contends there was still no difference in the breast cancer mortality rates.

What To Do

Despite the study results, Baxter contends that women who are comfortable doing self-exams should keep on doing them -- and all women should continue to bring to their doctor's attention any irregularity they find in their breast. "When breast cancers are found by women, it's usually in the shower or during sexual relations" not just during a self-exam, says Baxter.

"You should not ignore anything you find -- no matter how you find it," says Baxter.

Reichman takes a much firmer stance on the need for breast self-exams.

"If you're not doing a self-exam, you should start -- if you are doing a self-exam, you should continue -- we may never have the clinical evidence that BSEs work, but we know that they do -- and we know these exams save lives now and will continue to save lives in the future," says Reichman.

Currently, the American Cancer Society advocates breast self-exams as an important lifesaving measure.

For more information on the importance of self breast exams visit the American Cancer Society by clicking here.

For specific instructions on how to perform a through self breast exam, click here.

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