Experts Debate Value of Breast Self-Exams

Patty Myers dodged a bullet two years ago.

With a family history of breast cancer, Myers says she had performed a breast self exam, or BSE, from the relatively young age of 20 on the advice of her mother.

"I had never really felt anything abnormal or unusual," she recalls. "But when I was 28 years old I felt something that was not normal, something that gave me pause."

Her discovery prompted a visit to the doctor. The lump in Myers' breast turned out to be a cancerous tumor in its early stages. Surgeons removed the tumor and Myers underwent radiation and chemotherapy.

Now 30, Myers -- who has since become the director of operations for the patient advocacy group -- says she is breast-cancer free. And she credits breast self examination for the early detection.

Woman getting a mamorgram

"For me, BSE was so important, because women my age do not get mammograms; it's not covered by insurance," she says. "I had talked to my doctor about getting a mammogram, and the recommendation was for me to start at age 30.

"Had I not been doing [BSE], I presume my cancer would not have been detected until I started getting mammograms, and God knows what it would have been by then."

Although Myers says her experience made her a believer in self exams, a review published in the Cochrane Library in 2003 suggested that teaching and encouraging women to conduct self screening may be of little if any use when it comes to decreasing the death risk from breast cancer.

And, in the latest update to this review, which Cochrane released today, Danish researchers further downplay the importance of breast self examination.

"Self-exams are no longer recommended in Denmark, as they have no benefits, only harms," review co-author Dr. Peter G√łtzsche, director of the Nordic Cochrane Centre and Lecturer in medical science theory and ethics at Copenhagen University, told

The harm, G√łtzsche said, comes into play when women find lumps in their breasts that are not breast cancer -- discoveries that he said lead to unnecessary medical procedures and unnecessary worry. Even when a medical procedure is not necessary, a breast cancer false alarm can lead to emotional turmoil that can affect relationships and other aspects of day-to-day life.

"Doctors should not recommend harmful interventions with no proven benefits," he said. "They should explain to the women that self-examination is such as intervention."

The updated review has reignited the debate about breast self exams among breast cancer experts. On one side are doctors who agree with the premise of the review -- that encouraging women to conduct breast self exams does little when it comes to enhancing survival rates from breast cancer.

"The conclusion of the study that the data does not support using BSE as a good screening test for breast cancer is correct," says Dr. Susan Love, president and medical director of the Dr. Susan Love Research Foundation. "The randomized studies are large and well done."

Dr. David Euhus, chair in breast cancer surgery at the University of Texas Southwestern Medical Center at Dallas, says, "I have many patients who confess that doing a breast self exam increases their anxiety considerably. Some of the smartest and most reasonable ones decided long ago to stop examining their breasts. They were right."

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