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    Breast Self-Exam Flunks Test

    <P>They Don't Cut Breast Cancer Deaths, but May Increase Unnecessary Biopsies</P>


    "I don't want to tell women not to examine their breasts, but it is definitely not a substitute for mammography," Thomas tells WebMD. "Women should go regularly to get mammograms and to get examined by professional personnel. Formal breast examination includes palpation in a proper way using the pads of the three middle fingers, systematic searching of the whole breast in both sitting and lying positions, and looking for asymmetry. That takes time and a real effort. That is what a woman has to learn if wants to do BSE. It is more than looking at a card in the shower."

    Harris says that the time doctors spend teaching BSE could be better used in giving more thorough clinical examinations. But Baines insists that women who want to learn BSE should be encouraged to do so.

    "Trained eyes see more than untrained eyes. Trained fingers feel more than untrained fingers. Women who do BSE regularly have more trained eyes and more trained fingers," Baines says. "When women find their own tumors, they are more likely to do it if they do BSE -- regardless of how they actually notice them. I approve of the concept of breast self-awareness."

    Harris doesn't dispute this. "Part of what Dr. Baines is saying is right," he says. "We need trained minds to understand. But training those fingers is darn hard. It is a very hard thing to learn. What's needed is a really excellent physical examination of the breast, whether by the woman or by her doctor. A haphazard exam isn't enough. Training people to do it in the right way is really important."

    There are many products on the market designed to make BSE easier. Baines thinks they are, at best, a waste of time and money.

    "You have no idea of the number of entrepreneurs who have made things like revolting collapsed balloons full of wet jelly, and women are supposed to lie on their backs like fish and palpate their breasts with them," she says. "These ways to enhance BSE -- do I give them credence? No. The closer your fingers are to your breast, the better."

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