Breast Self-Exams: More Biopsies But No Lives Spared

Five years ago the American Cancer Society discontinued its recommendation that women perform monthly breast self-exams (BSEs) to help detect the presence of masses or lumps at the earliest possible moment, saying instead that women should continue the exams if they are more comfortable doing so. Now a recent study that has followed up on the number of breast cancer deaths in women who do and those who do not perform regular BSEs has revealed no significant difference between the two.

In fact, women who do BSEs are more likely to undergo biopsies when no trace of cancer is present than women who do not do the exams, prompting some members of the medical community to consider BSEs more harm than good. Regardless of performing BSEs or not, 50% to 60% of all suspicious breast masses are first detected by women themselves, who then seek medical analysis.

The follow-up study, conducted by researchers at the Nordic Cochrane Centre, has reached a conclusion similar to that of a 2003 study. In the most recent follow-up study, the cases of 388,535 Russian and Chinese women were evaluated. Of the study group, 3,406 biopsies were performed on women who did BSEs and only 1,856 biopsies were done in the group that did not do the self-exams. In spite of the higher number of biopsies in the BSE group, there was little difference in the rate of death due to breast cancer in either group of women.

In a study that involved just the women from China, the rate of mastectomy and more conservative forms of surgery, such as lumpectomy, was almost the same, whether or not BSEs were used.

Details of the study, co-authored by Jan Peter Kosters, PhD, and Peter Gotzsche, PhD, both of the Nordic Cochrane Centre, can be found in The Cochrane Library, a regular publication of The Cochrane Collaboration. The collaboration is an international organization whose mission is to evaluate medical research by means of systematic reviews for both quality and content.

Filed under: Breast Cancer, Medical Research, Prevention, Women's Health