Breast Screening, Revised.

Calling all women: I've got an important article for you to read linked here. To summarize the article, self-breast exams are no longer recommended.

According to the article, self-breast exams "...[fail] to show a benefit...in contrast, there is good evidence of harm from [self-breast exam] instruction, including significant increases in the number of physician visits for the evaluation of benign breast lesions and significantly higher rates of benign biopsy results" (Baxter, 2001).

Right now the guidelines state that clinical breast exams (i.e. those performed by a doctor) and mammographies are only to be performed on women aged 50-69 years old (unless, of course, there are breast cancer symptoms or immediate family history (apparently cousins and aunts with breast cancer don't affect your individual risk. Actually the biggest risk factor for breast cancer is age).

However, the paper ends with this statement: "To conclude, many breast tumours are discovered by women themselves, and although the evidence does not support routinely teaching breast self exams [BSE], women should be instructed to promptly report any breast changes or concerns. Any woman who wishes to practise BSE and who requests instruction should be counselled regarding the risks and benefits, and the health care professional should ensure that BSE instruction is thorough and that the woman is performing BSE in a proficient manner" (Baxter, 2001).

...I couldn't agree more! I'm all about self-awareness and empowering people about their health (hello Naturopathy!), and am thus totally supportive of women who want to regularly perform BSE. However, I think that they should first be taught by a doctor so that they know exactly what they are looking for and how to properly perform the technique, covering the entire rectangle of 'at risk' skin. Given my breast exam training earlier this month, I can say that the self breast exam handouts distributed by Cancer Societies are definitely not clear or thorough enough.

When you feel breast tissue, it feels super lumpy and bumpy, which is no wonder so many women feel breast "lumps". In addition, breast tissue is cyclic, meaning it changes texture, shape, and size to coincide with the menstrual cycle. Which leads into another major concern: frequency. In order for BSE to be effective, the breast has to be palpated routinely, meaning the same time every month (this accounts for the cyclic changes of the breast). Palpating every month is important because the breast also changes with age, so if it's been a year between exams, it may feel very peculiar, causing unnecessary alarm.

So my female readers: please talk to your doctor about your breast health and discuss what is best for your situation. If you want to learn BSE, then ask to be taught. And if you want to be extra prepared, tag along a copy of the article and show it to the doc!

Lastly on the topic of breast health, if you want to learn more about breast cancer "charities", you may want to check out this documentary, Pink Ribbons, Inc. (movie poster pictured above). Unfortunately, I have not yet seen the full film, but the movie trailer is certainly thought provoking!

1 comment:

  1. As you know I recently had a second mammogram,in a fairly short duration, following up on two "disappearing lumps" aka perimenopausal breast tissue changes.
    I do not blame the health care practioners for sending me for the mammograms and ultrasound at all, but I will not return for a few years due to my age and negative hx as I've been told the intensity of radiation during a mammogram does my breasts no good.
    My MD & team no longer perform routine breast exams.
    There definitely is a change out there.

    Glad you blogged about this - ladies talk to your medical team!



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