The updated review, published in the Cochrane Library, is in line
with the findings from the original review, published in 2003.
"We would like to inform women that there is no evidence from two large
studies that screening by regular breast self-examination (once a month)
improves their chances of surviving breast cancer, whereas there is evidence
that regular breast self-examination almost doubles their risk to undergo a
biopsy," reviewer Jan Peter Kosters, MD, of the Nordic Cochrane Centre,
tells WebMD via email.
Breast Self-Exam Report
The new review is based on two studies that together included more than
388,500 women in Russia and China who ranged in age from 30-66.
Some of the women were trained to do breast self-exams. They also got
regular reminders or refresher classes to make sure their technique was
correct. For comparison, the other women in the studies weren't taught or urged
to do breast self-exams.
The women were followed for 10 years. During that time, 587 women died of
breast cancer, with similar numbers of deaths in the breast self-exam group
(292 breast cancer deaths) and in the group of women who weren't trained to do
breast self-exams (295 breast cancer deaths).
The women who did breast self-exams were nearly twice as likely to get
breast biopsies, many of which turned out not to show cancer.
In short, doing breast self-exams made no difference to the groups' breast
cancer survival rates, and it boosted the biopsy rate.
Do Breast Self-Exams or Not?
The decision about whether or not to do a breast self-exam needs to be made
by the women themselves, says Kosters, adding that "a rational choice would
be not to do regular breast self-examination."
Doing a breast self-exam is "an option," Debbie Saslow, PhD, the
American Cancer Society's director of breast and gynecologic cancer, tells
WebMD. "We don't want to recommend against it but there's no evidence to
recommend for it."
"Certainly, if any woman wants to do breast self-exam, then her doctor
should give her assistance and make sure that her technique is what it should
be, and also let her know what the limitations are so that she's not expecting
that this is going to have big impact on her if she gets breast cancer,"
Susan Love, MD, president and medical director of the Dr. Susan Love
Research Foundation, calls the review a "wake-up call to say, 'You know
what? We've been relying on things that don't work that well and we really have
to start demanding something that works better.'"