Controversy Over Breast Self-Examination

August 2008 - A review by the Nordic Cochrane Centre published in The Cochrane Library into the effectiveness of regular breast self-examination concludes that despite its promotion in health advice to women there is no evidence that it has contributed to a reduction in breast cancer deaths. Indeed, it has resulted in twice as many negative biopsies.

Researchers analysed data from two large studies of 388 535 women in Russia and China. Women who used breast self-examination had 3406 biopsies compared with 1856 biopsies in those who did not. There was no significant difference in breast cancer deaths between the two groups. Treatment protocols included in the Chinese study found similar rates of mastectomy and breast-conserving surgery such as lumpectomy in both groups.

Jan Peter Kosters, Ph.D. and Peter Gotzsche, Ph.D. concluded:

"At present, screening by breast self-examination or physical examination [by a trained health worker] cannot be recommended."

The authors nonetheless acknowledge that some will choose to continue the practice.

Carolyn Runowicz, director of The Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center, supports breast self-examination by women comfortable with the practice, noting that 50 to 60 per cent of breast masses are found by women themselves.

Carolyn Runowicz commented:

"I think what we are seeing is that women are familiar with their breast through breast self-exam and when there is a lump, they notice the difference."

Jan Peter Kosters added:

"Women should always seek medical advice if they detect any change in their breasts that might be breast cancer. We suggest that the lack of supporting evidence…should be discussed with these women to enable them to make an informed decision."

Related Articles

• 20,000 New Cancer Cases A Day Worldwide
  A report from the American Cancer Society estimates that 2007 saw over 12 million new cancer cases and 7.6 million cancer deaths (about 20,000 a day) worldwide. Of these, 5.4 million cases and 2.9 million deaths occurred in economically developed countries, compared to 6.7 million cases and 4.7 million deaths in developing economies.
• Braking Genes and Cancer Cell Division
  Researchers have identified a number of genes involved in the mechanism that prevents uncontrolled cell division and found that aberrations are linked to certain types of cancer as well as to the relative aggressiveness of the disease.
• 21st Century Breast Cancer Management
  New developments in breast cancer imaging, timing of chemotherapy, and vaccine research may offer innovative non-surgical interventions resulting in significant changes to current screening and treatment practice and improvements in patient care.
• Cancer Care
  Women with breast cancer who are obese, less educated or have lower household incomes may be more likely to receive reduced doses of chemotherapy thereby jeopardizing their survival.
• Health Benefits of Olive Oil
  New research suggests that significant differences in cancer rates between northern and southern Europeans may be explained by the anti-cancer effects of olive oil in the diet.
• Combination Therapy and Breast Cancer
  Radiation therapy and chemotherapy administered concurrently after lumpectomy helps prevent local reoccurrence of breast cancer.
• Search For Better Breast Cancer Drugs
  A joint initiative between computer scientists at the University of Edinburgh and cellular biologists at the Riken Genomic Research Centre in Japan may result in improved drug treatments for breast cancer sufferers that will also minimize side effects.
• Lymph Node Sampling Compromises Cancer Survival
  A new study concludes that most patients who undergo gastric cancer staging by lymph node sampling have inadequate assessments that compromise survival.