FEATURE — If you have annual clinical breast exams and do breast self-exams, will this reduce your chances of dying of breast cancer?
The answer is, unfortunately, no.
For some background on this stark answer, a public health intervention is any attempt to improve the health of a population of people. The problem is, people began to promote and teach breast self-exams as a public health intervention long before it had been adequately studied and long before we knew if it worked.
For the past few decades, many organizations have strongly recommended that every woman age 20 and older perform a self-exam each month. Many of these organizations have spent considerable resources on shower cards, educational programs and videos that instruct women how to use proper technique, and some companies even produce and sell models of the breast for the purpose of teaching women how to perform the exams.
In addition, many physicians and nurses spend time promoting breast self-exams and teaching the technique to their patients. Due to these efforts, many women have come to believe that the exams are a lifesaving intervention, even though there is no evidence showing this to be true.
There are still a lot of places on the internet that either suggest or come right out and it is beneficial, but after sifting through a huge amount of evidence to the contrary from around the world, we are left with these conclusions:
- There is currently no scientific evidence from randomized trials that breast self-exams save lives or enable women to detect breast cancer at earlier stages.
- Some data shows that self-exams greatly increases the number of benign – or noncancerous – lumps detected, resulting in increased anxiety, physician visits and unnecessary biopsies.
In one study, for example, only 7.6 percent of breast cancer patients who had practiced self-exams on a regular basis actually found their breast cancers while performing the exams. Thus, it is unclear whether the practice aids women in discovering breast cancer.
In another example, two very large trials with hundreds of thousands of women in Russia and China randomized into equal groups, half taught breast self-exams, half instructed not to.
After 10 years, mortality was equal in the two groups. The group that did self-exams had more biopsies done for benign masses. This is considered a negative outcome due to the cost, invasiveness, worry, and scarring and disfigurement from being biopsied.
Therefore, the National Institute of Health and numerous other groups do not support efforts to promote and teach self-exams on a population-wide level in any age group of women.
Our limited resources need to be focused on strategies with proven benefit and breast self-exams shouldn’t be taught in such a way that gives women a false sense of security. In my practice, I see many women who bypass mammography because they say their breast self-exam was “normal.”
I don’t know why material dated 2018 on the internet is still pushing this practice, but the data isn’t there to back it up. But now you know. The more you know, the better you can make decisions on your own body.
- Dr. Sean Lynn practices at St. George Women’s Health Center in St. George | Telephone: 435-218-7770.
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