There have been major changes in the way doctors check for breast cancers. A breast examination is considered to do more harm than good, as women have lumpy breasts at the best of times – so too many unecessary biopsies and Xrays are undertaken. The same results from women doing a self examination, which also no longer recommended by the experts.
Breast Self Examination (BSE):
This is no longer recommended by any of the reputable medical organizations. This is because women’s breasts tend to be lumpy, and so women will often find lumps. This leads to unnecessary investigations, Xrays, Biopsies and anxiety and stress, until women know whether it is benign or not.
Regular self-examination or clinical examination for early detection of breast cancer.
Published Online: 8 OCT 2008
Assessed as up-to-date: 8 OCT 2007
Breast cancer is a common cause of cancer morbidity and mortality in women. Breast self-examination (examination of the breasts by the individual) or clinical breast examination (examination of the breasts by a doctor or a nurse) have been promoted for many years as screening methods to diagnose breast cancer at an early stage, in order to decrease the risk of dying from breast cancer. This review searched for well-designed trials that assessed these methods and found two large population-based studies involving 388,535 women who compared breast self-examination with no intervention. The review of data from these trials did not find a beneficial effect of screening in terms of improvement in breast cancer mortality. The trials showed that women who were randomised to breast self-examination were almost twice as likely to undergo a biopsy of the breast, with 3406 biopsies performed in the screening group compared to 1856 biopsies in the control group. The only large population-based trial of clinical breast examination combined with breast self-examination that was identified was discontinued. This was because of poor compliance with follow up and no conclusions can be drawn from the study.
Some women will continue with breast self-examination or will wish to be taught the technique. We suggest that the lack of supporting evidence from the two major studies should be discussed with these women to enable them to make an informed decision. Women should, however, be aware of any breast changes. It is possible that increased breast awareness may have contributed to the decrease in mortality from breast cancer that has been noted in some countries. Women should, therefore, be encouraged to seek medical advice if they detect any change in their breasts that may be breast cancer.
Screening for breast cancer: an update for the U.S. Preventive Services Task Force. 2009.
Mammography screening reduces breast cancer mortality for women aged 39 to 69 years; data are insufficient for older women. False-positive mammography results and additional imaging are common. No benefit has been shown for clinical breast examination or breast self-examination.
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