Are you surprised about this past week's news on breast self-exams (BSE)? The Cochrane Collaboration reported that Jan Peter Kosters, Ph.D., and Peter Gotzsche, Ph.D., of the Nordic Cochrane Centre, updated their 2003 review of BSE studies. Kosters and Gotzsche's conclusion remains the same: "At present, screening by breast self-examination... cannot be recommended."
This information was shocking to many women, who have been inundated for years with messages about the importance of a strict regimen of monthly breast self-examinations. But NBCC has been saying for some time that there is no evidence to support this recommendation. The key concept to understand is that from a public health perspective, any screening intervention must have a demonstrated effect in decreasing mortality. Here is the first paragraph of NBCC's 2003 position paper on breast self-examinations:
"There is currently no scientific evidence from randomized trials that breast self-exam (BSE) saves lives or enables women to detect breast cancer at earlier stages. In addition, there are some data that show that BSE greatly increases the number of benign lumps detected, resulting in increased anxiety, physician visits, and unnecessary biopsies. Therefore, NBCC does not support efforts to promote and teach BSE on a population-wide level in any age group of women. NBCC does not support any public health intervention until there is good scientific evidence that the benefits outweigh the risks."
The reality of the lack of effectiveness of breast self-examinations is one of the reasons that NBCC has fought for increased funding for breast cancer research. One of the areas demanding more resources is developing better screening techniques for breast cancer -- ones that will prove to be effective and more accurate than current methods such as mammography and that will save lives. This year some 250,000 Americans will be diagnosed with breast cancer and more than 40,000 will die from the disease.
There is no time to waste on things that do not work, no matter how much we want to believe otherwise. We need an effective, evidence-based screening process - not an unreliable myth that causes more problems than it solves. Want to make a difference?
First, know the facts: read NBCC's complete position paper on breast self-examinations. Then, join NBCC -- and help us do the hard but exhilarating work of eradicating breast cancer. As this story illustrates, there is still a lot we do not know and a lot of ground to cover. We need committed grassroots advocates like you who will demand the right research, and screening and treatments that are based on hard science. If we continue to keep our standards high, we will achieve our mission.
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