Are Breast Self-Exams Still a Valuable Tool?
Study Shows No Reduction in Breast Cancer Deaths Among Women Who Self-Examine
Similar Rates of Cancer
Semiglazov's study looked at whether an intensive program of BSE instruction would reduce breast cancer mortality. Between 1985 and 1989, 96,000 women who were between 40 and 64 years old were taught BSE in intensive training sessions. A comparison group of women were given no instruction. For all women in the study, abnormalities on breast exams were biopsied, and the women were treated according to their diagnoses.
Among the women trained to do breast self-exams, 7,061 reported abnormalities, compared with 3,825 in the comparison group. The researchers found 1,032 benign (noncancerous) breast lesions in the BSE group and 547 in the comparison group.
But despite finding more abnormalities, the two groups had similar numbers of cancers diagnosed -- 733 and 702, respectively. Fifteen years after they were diagnosed with breast cancer, both groups had similar survival rates, 53.8% in the BSE group and 51.1% in the comparison group.
"We had a hope that in BSE we would have a low-tech screening method that would work in [countries] with limited resources, where mammography screening isn't feasible," Holmberg says. "Sadly, the results didn't show that BSE could be seen as a substitute."
Exam Still Useful
"A lot of people don't interpret correctly the results of this study and another study from China with similar results," Therese B. Bevers, MD, tells WebMD.
"They think that because the intensive teaching of BSE doesn't reduce mortality, that women shouldn't examine their breasts," says Bevers, who was not involved in the study. "I firmly believe that women need to know what their breasts feel like and promptly report any change. This study says there's no right way to do it. Women already do a great job; they can find masses without anyone instructing them." Bevers is chairwoman of the Breast Cancer Screening Guidelines Panel of the National Comprehensive Cancer Network.
She says that enormous amounts of resources are used to teach women how to do the specific system of breast self-exam, ranging from individual doctor office visits to the printing of shower cards. "I say, 'Know what your breasts feel like and report changes.' If you don't feel a difference, there's probably nothing different. If you feel something different, call your doctor. There's no magic to checking your breasts."