Re-examining Breast Self-Exams

…Have the benefits been oversold? In this month of Breast Cancer Awareness, we answer this question for you.

For the past half century, women have been encouraged to perform a monthly breast self-exam – and may feel remiss or even guilty if they don’t do it faithfully. You may have been given pamphlets to read, videos to watch, and a card to hang in the shower – or even hands-on instruction courtesy of a silicone breast model with hidden lumps to feel for. But what’s the evidence that this monthly ritual helps in early breast cancer detection and actually saves lives? You may be surprised to know it’s actually slim to nil.

Where’s The Proof?

In its last update, the US Preventive Services Task Force – an independent panel of experts that makes evidence-based health recommendations for the Government – advised against clinicians teaching breast self examination. It cited evidence suggesting that the exams do not reduce breast cancer deaths and some evidence that they cause harm. The harm includes false alarms, which can lead to unnecessary procedures (notably more biopsies of benign lesions) and extra worry.

For example, a large US study in the ‘Journal of Cancer Education’ found that women who did breast self-exams had more unnecessary diagnostic mammograms; and for those diagnosed with breast cancer, breast self exam performance did not correlate with reduced severity of the disease. Breast self-exam ‘did not show any advantages with respect to tumour outcomes’, the authors concluded.