Breast self exam does not reduce breast cancer risk

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A review of recent studies says there is no evidence that the monthly breast self-exam to check for lumps or other changes that might signal breast cancer actually reduce breast cancer deaths.

Instead, the practice may be doing more harm than good, since it led to almost twice as many biopsies that turned up no cancer in women who performed the self-exams, compared to women who did not do the exams.

“At present, screening by breast self examination or physical examination [by a trained health worker] cannot be recommended,” Jan Peter Kosters, Ph.D., and Peter Gotzsche, Ph.D., of the Nordic Cochrane Centre, conclude in the review.

The review is an updated version of a 2003 review of studies, which came to a similar conclusion.

Debbie Saslow, Ph.D., director of breast and gynecologic cancers for the American Cancer Society, said the organization revised its guidelines and stopped recommending monthly breast self-exams five years ago in light of the evidence that had emerged. The guidelines now call the monthly exam “an option” for women beginning in their 20s.

“We are advising 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,” Saslow said. “Women who want to should keep doing breast self-exam, and women who don’t want to, don’t need to.”

The review authors recognize that some women will want to continue with breast self-exams and women should always “seek medical advice if they detect any change in their breasts that might be breast cancer,” Kosters said.

“We suggest that the lack of supporting evidence?should be discussed with these women to enable them to make an informed decision,” he said.

Carolyn Runowicz, director of The Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center, encourages women to do the self-exams if they are comfortable with them, noting that 50 percent to 60 percent of women detect their own breast masses.

“I think what we are seeing is that women are familiar with their breast through breast self-exam and when there is a lump, they notice the difference,” she said.

The new review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research.

Source: Center for the Advancement of Health, USA

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