Breast self-exams don’t help. Or do they? *

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Do you make a point of regularly checking your breasts for suspicious lumps that might bear further investigation? My doctor told me to do just that at my last physical.

But overall, such exams do little to prevent deaths from breast cancer and ‘cannot be recommended,’ according to a review of two large trials of 389,000 women -- and may even do more harm than good. That’s because people who check their breasts have nearly twice as many biopsies exploring lumps that turned out to be harmless. Exams by trained doctors aren’t to be recommended either, for the same reason, report authors of the review, conducted by the Cochrane Collaboration. (It’s an update of an earlier, 2003 review by Cochrane on the same topic.)

The position of cancer specialists is more nuanced, it appears, from a report at the Center for the Advancement of Health. In fact, it doesn’t exactly seem that cancer experts entirely want to dump the breast exam.

In that report, Debbie Saslow, (I mispelled Debbie Saslow’s surname as Sazlow in an earlier version of this post. Apologies!) director of breast and gynecologic cancers at the American Cancer Society, says that as a result of the 2003 findings, the American Cancer Society changed its guidelines to no longer recommend such exams. Instead, it lists them as ‘an option.’ Saslow does say that women should ‘be aware of what is normal for how their breasts looked and felt, and to promptly report any changes to their health care provider.’ That sounds awfully like examining one’s breasts, though the ACS does state that breast awareness is more important than a structured exam -- indeed, most changes women detect fall outside of a structured exam. The cancer society does recommend regular clinical breast exams by a healthcare professional -- and states they should last from 6 to 12 minutes(!). (You can read about that, and lots more about breast cancer, right here.)

We checked the website of the National Cancer Institute, which permits, but doesn’t recommend, self-exams: ‘You may perform monthly breast self-exams to check for any changes in your breasts ... you should contact your health care provider if you notice any unusual changes in your breasts ... studies have not shown that breast self-exams alone reduce the number of deaths from breast cancer.’

And in the Center for Advancement of Health report, Carolyn Runowicz of the University of Connecticut Health Center ‘encourages women to do the self-exams if they are comfortable with them,’ the article notes. She says that 50% to 60% of women detect their own breast masses.

All a tad confusing? Here’s an article at U.S. News and World Report that attacks the topic in more depth.

--Rosie Mestel