Like many women, I’ve felt guilty about my slipshod breast exams for years. Sure, I’ll give the girls a good once-over in the shower now and then, but I’ve never diligently gone through all the motions (circular and otherwise), month in and month out.
So it was with a certain amount of relief that I read a new analysis confirming that the breast self-exam (or BSE) truly doesn’t make much of a difference after all.
According to a review by the Cochrane Collaboration, an international organization that evaluates medical research, there’s no evidence that self-exams actually reduce breast cancer deaths. In fact, the often-recommended monthly chore may even do more harm than good, according to the group’s analysis of a pair of studies of nearly 400,000 Chinese and Russian women.
“Data from two large trials do not suggest a beneficial effect of screening by (BSE) but do suggest harm in terms of increased numbers of benign lesions identified and an increased number of biopsies performed,” concluded the authors in Tuesday’s issue of The Cochrane Library. “At present, screening by breast self-examination … cannot be recommended.”
One fewer thing to do?
Chris Herget, a 44-year-old notary public from Bellevue, Wash., says while she’s surprised to hear this news, she, too, feels relieved.
“I’ve never really felt competent doing it myself anyway and I have very fibrous breasts so everything feels like a ‘pea,’” she says. “In fact, the first time I told a doctor that I thought I’d found a lump, he was like, ‘That’s nothing, that’s a fat cell.’”
But the news that the BSE is officially on the way out perplexes others.
“I guess it’s one less thing that I need to be doing, but it is a little confusing,” says Liz Lane, a 29-year-old public relations manager from New York City. “Now I’m not sure what I am supposed to do to check myself.”
The issue is complicated, acknowledges Dr. David B. Thomas, breast cancer epidemiologist at Seattle’s Fred Hutchinson Cancer Research Center and professor of epidemiology at the University of Washington.
“It’s important to separate out the public health implications from the implications for an individual woman,” says Thomas, who is also the author of the 2002 landmark study involving more than 250,000 Chinese women that was analyzed and affirmed by this latest review.
“If a woman is highly motivated — let’s say her mother or sister has been diagnosed with breast cancer — then of course she should practice breast self-exam. But that’s a different situation than trying to reach women on a mass scale. Our study shows that that’s probably a waste of time. You’re not going to get women sufficiently motivated to practice it well enough and frequently enough to make that big of a difference.”
Lumps and bumps can be normal
What’s more, Thomas says BSEs can be problematic because the lumps and bumps women do report often turn out to be benign.
“The price you pay for doing more thorough breast exams is you’re going to find more benign lesions and that will result in unnecessary surgical procedures,” he says.
Rhebe Greenwald, a 65-year-old retired art director and systems analyst from Port Townsend, Wash., has experienced this firsthand.