Physicians, Advocates, Women Continue Debate Over Efficacy Of Breast Self-Exam, New York Times Reports
January 5, 2007 – 9:08 pm | posted in Breast Cancer, Women's Health / OBGYNThe New York Times last week examined the debate among women, physicians and some advocates over whether breast self-exams are effective and necessary. The Journal of the National Cancer Institute in 2002 released a study that enrolled 266,064 textile workers ages 30 and older from Shanghai, China — half of whom had performed self-exams regularly and half of whom had not. The study found that after 10 years follow-up, the same number of women had died of breast cancer in each group. In addition, breast cancers among women who did breast self-exams were not diagnosed “at a smaller size or at a less-advanced stage,” according to the study. The researchers concluded that doctors should stop teaching the breast self-exam, spend more time on clinical breast exams and seek other ways to teach women about painless lumps. The American Cancer Society in 2003 announced that breast self-exam was optional because research showed “structured” breast self-exam “is less important than self-awareness,” the Times reports. The ACS policy has “met resistance from women who believe self-exams save lives, from doctors who question the research and trust their clinical and personal observation, and from breast cancer advocates, some of whom are on the fence.” Barbara Brenner — executive director of the group Breast Cancer Action, who found her own cancer by doing a self-exam — said, “Early detection only matters to some people, [b]ut for those to whom it matters, if you find it early and the treatments work for you, your chance of living long are great.” Christy Russell, co-director of the Norris Lee Breast Center at the University of Southern California and an ACS spokesperson, said that doctors can teach women about breast self-exams if they request instruction but that women must be informed of the risks, such as needless biopsies and the “potential harm if women say, ‘I have a normal [breast self-exam], I have no need for a mammogram.’” According to Susan Brown, manager of health education at the Susan G. Komen Breast Cancer Foundation, the demand for breast self-exam instructional cards has increased in the last year, possibly because many organizations no longer provide the cards. Breast cancer affects about 11,000 women under age 40 in the U.S. annually. Self-exams might be most useful to women in this age group because they are too young for mammograms, the Times reports (Ferraro, New York Times, 12/26/06).
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