Are Breast Cancer Self Evaluations Useful and Important?

Beth Brophy Health Guide
  • You would think that I would be a big proponent of breast self-exams, as I was the one who first diagnosed my own breast cancer. But it wasn’t a tell-tale breast lump that tipped me off, it was a dimple that sent me straight to the doctor. In the intervening 11 years, I haven’t been too big on self-exams, as I see my breast cancer oncologist every four months, my breast surgeon every four to six months, and my gynecologist once or twice a year. Then there’s my annual mammogram. I figure that with all those professionals examining me, I’m covered.

    Thus, I read with great interest this week, an article in the New York Times with the arresting headline: “Self-Exams Are Passe? Believers Beg to Differ.”
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    The gist: Low compliance of women doing self-exams, more anxiety and more unnecessary breast biopsies among those who do, and a 2003 policy by the American Cancer Society stating that self-exams should be optional, following a 2002 study that concluded self-exams weren’t all that useful. The study tracked 266,064 Shanghai textile workers 30 and older. Half did self-exams. No other screening was used. Ten years later, the same number of women in each group died of breast cancer, and those who did self-exams did not have smaller or less advanced cancers.

    Ever since that 2002 study, doctors and patient advocates continue to disagree over the usefulness of self-exams, and have adopted different recommendations for patients. Some say do it, others say don’t bother. Some say the general population should forget about it, but high-risk women—those who carry the breast cancer gene, or younger women with dense breasts who are too young for regular mammograms should still do self-exams.

    The demand for the cards instructing women how to do self-exams has grown. The Susan G. Komen Breast Cancer Foundation has ordered a million of those cards for 2007 and expects to re-order more in six months.

    My conclusion, after reading the article, was that the argument for or against self-exams could be interpreted either way. Those who think self-exams may clue them in to a potential abnormality will continue to do them. Others, like me, will mostly leave it to their doctors. What do you think: are self-exams important to you or not?

Published On: December 27, 2006