
Many of my patients come in 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.
— Dr. Kate
I was greatful reading this.
I started to have a professional exam with a breast cancer physician at 45 – breast exams are not recommended earlier than that as they often lead to biopsies.
Self-examination has been totally discredited and my Dr says it’s better to be “breast aware” – to take note of shape, look and colour when you’re drying yourself after a shower.
I think the emphasis on cancer is a bit unhealthy – I try to keep it all in perspective.
We don’t have routine gyn exams in my country and pap smears are “offered” from age 30 and then 5 yearly until 50,55 or 60 (depending on past results and risk profile) No woman is forced or pressured to have smears – they have risks, so it must be YOUR decision.
Women are given clear risk information and there are no scare campaigns.
As a very low risk woman, I was told that I’d be unlikely to benefit, but if I wanted them, I was likely to face at least one false positive and biopsies in my lifetime. (55% of Finnish women face biopsies (only a very small number have any sign of malignancy) – in the States it’s a whopping 95%)
I made an informed decision not to have screening. (I will also decline breast screening – the evidence against them is very strong – new research suggests they may INCREASE the risk of cancer because of the radiation and bruising of the breast tissue)
If you have mammograms, be very careful before age 50 – they are VERY likely to lead to biopsies in women under 50.
I was a bit shocked to read of all the invasive exams that are recommended annually for US women.
In my country, our doctors are opposed to over-examining and over-screening as it leads to over-treatment and harm.
It also means you lead lives focused on cancer and medicalized to a high degree….
I think the healthiest approach is to adopt a balanced view – one that gives YOU the best protection without becoming a permanent patient.
Womanhood isn’t a disease.
Is there a way to locate someone locally to try this?
My wife has had both breasts removed because of cancer. Soon after she started chemo I was talking to some friends about the preventative measures she had taken because she had a strong family history. One woman went home and told her husband that she had not done a self exam in a long time. They both did an exam and her husband asked about a lump he felt. Within two weeks a biopsy found a malignant lump and she eventually had the breat removed with no chemo required. She was so thankful that was willing to talk so directly about the subject.
I would recommend that women who have a family history of breast cancer be more vigilent.
It has been over 5 years since my wife’s diagnosis and she doing fine and is as beautiful as ever.
AJ
I don’t have breasts, but I do perform regular testicular exams, guided by a pamphlet I found at a local hospital.