BREAST SELF – EXAMINATION
Is monthly breast-self examination still the norm?
Right now regular monthly systematic breast self-examination for an asymptomatic average-risk woman is no longer recommended. Associations such as the American Cancer Society and the National Breast Cancer Coalition also adopted this line of practice.
This can be very confusing because for generations women have been told to do them but studies have shown that this practice in a large population led to unnecessary diagnostic tests and biopsies, which could lead to overdiagnosis, overtreatment and created anxiety.
It also showed that in a setting where it was used combined with screening mammography, it had little benefit in detecting cancer and also in extending life. In fact, most lumps found were normal.
What is the present recommendation then?
Nowadays, the recommendation is breast self-awareness, in other words even though women don’t have to perform monthly breast self examination, they should become familiar with the appearance and feel of their breasts and seek medical opinion if changes occur. Experts have concluded that this is as effective in detecting breast cancer as monthly BSE.
And how do you practice breast self-awareness?
Women should know the feel and look of their breasts through regular activities such as dressing or showering or sex, and notice changes such as lumps, skin dimpling, deformities or discharge and report these to their physicians when it occurs.
Of course, if a woman has done a breast self examination before, this does help her “get to know” her breast.
What is the take home message?
First of all – know your breasts. Whichever is the means you take to do that, a woman should know what her breasts look and feel generally.
If a woman doesn’t want to examine her breasts on a monthly basis because that makes her uncomfortable or anxious, I acknowledge the fact that studies have not proven otherwise. However, she should be told to still keep an eye on changes her breast may have and not ignore them completely.
However, if a woman wants to advocate for herself and do monthly breast self-examination, she should do it. This will not cause her any harm and on an individual basis as little consequence – it’s just not shown to have benefits on a large population.