Many of my patients have come in lately for their yearly check-ups, and as I do their breast exam, they confess that they haven’t been checking themselves as regularly as they ought to. But there isn’t really a clear answer as to whether or not women “should” perform breast self-exam (or BSE) on a regular basis. There are doctors on both sides of the debate, and if you search the web you’ll find a plethora of opinions. I tell my patients that there are two arguments to be made:
Reasons to perform routine BSE:
- Most lumps that turn out to be cancer are found by the woman herself.
- Knowing your own breasts — how they normally feel, what they normally look like — is essential for knowing when something doesn’t seem right.
- Many doctors, unfortunately, don’t perform a thorough breast exam at your annual exam (how long did your doctor spend on your girls the last time you were there?).
Reasons NOT to perform BSE:
- Many young women have “lumpy” breasts, and have a hard time distinguishing a “bad” lump from normal breast tissue.
- There’s no study that shows that routine self-exam is any better at detecting breast cancer than occasional exams (by you or your partner) or preventing breast cancer deaths.
- Routine exams, in fact, may increase the number of unnecessary biopsies that are performed for benign lumps.
- It may make you more afraid, to be thinking about cancer so regularly, and not actually be helping you feel better about your body.
- It’s one more thing to feel guilty about not doing (and you already feel guilty about not flossing, right?).
In the end, I support what each of my patients wants to do. If she doesn’t want to do BSE, no problem — I make sure she gets an annual exam from me. And if she does want to check herself regularly, I make sure she knows how to perform BSE and what to look for. There are many different resources available about how to properly perform a breast self-exam. Either way, you should know your body — but not approach it with worry.
Do you perform regular self-exams?
— Dr. Kate
Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.