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Breast Self-Exam Debate Finally Settled


Remember when your doctor told you to “feel your boobies” at least once a month in the shower (or wherever you prefer to grope yourself) to check for any changes? If you haven't heard this medical advice lately, it may be because the jury has long been out on whether self exams actually work to catch cancer and reduce breast cancer deaths. But finally a new paper published in the journal of Obstetrics & Gynecology has a definitive answer.

“The research has shown that the actual teaching of the self breast-exam and doing it monthly doesn't improve outcomes or long-term survival,” says lead author Katrina Mark, M.D., a clinical instructor in the department of obstetrics, gynecology, and reproductive sciences at the University of Maryland School of Medicine. The biggest proof of this is a large-scale Chinese study of 260,000 women who were divided into two groups: one was taught breast self-exams and the other wasn't. Women who followed the rigorous exam guidelines experienced significantly more biopsies—but were no more likely to detect breast cancer than the group that didn't perform exams. [Tweet this scary fact!]

Soon after this study and a few smaller, randomized trials, the U.S. Preventive Services Task Force Screening for Breast Cancer Guidelines declared the screening method ineffective in 2009, stating it might be doing more harm—both psychological and physical with unnecessary biopsies—than good. The American College of Obstetricians and Gynecologists and the American Cancer Society has since followed suit, recognizing that breast self-exams might be ineffective, costly, and anxiety-provoking, Mark confirms. But neither organization has flat-out recommended against the exams. In fact, they've just changed the wording from “breast self-exams” to “breast self-awareness,” which has caused a lot of confusion among patients and healthcare providers.

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“The idea of self-awareness is to communicate with your doctor if you notice something abnormal. But unfortunately it's still very linked to self breast exam in a lot of healthcare providers' and patients' minds, and it ends up falling back to the same-old monthly prescribed self breast-exam, which has been studied and disproven,” Mark explains.

Some doctors avoid calling it one or the other. “I think some of this discussion is a matter of semantics. I don't specifically label it for my patients. What I do tell them is to keep an eye on their breasts and look for any changes,” says Sharon Rosenbaum Smith, M.D., a breast surgeon at the Comprehensive Breast Center at Mount Sinai Roosevelt and Mount Sinai St. Luke’s. Incidentally, Smith has just diagnosed three new patients, 20-something-year-old women, who had detected their own breast cancer.

Your breast bet: You don't need to massage your breasts in circular motion once a month (unless you really want to). The important thing is to know the look, feel, and shape of your own breasts, says Stacy Lewis, chief program officer for the Young Survival Coalition, a national nonprofit organization focused on breast cancer in young women. Forget thinking of it as an “exam” or “awareness,” and just be sure to know your body so that you can let your doctor know when you see something suspicious such as lumps, discoloration, unusual discharge, or a change in skin texture.

What do you think of this new study? Will you continue to perform self exams? Let us know in the comments below or Tweet us @Shape_Magazine!


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