Breast self examination, or BSE
Breast self examination is a bit of a controversial topic within the medical community. It is unclear whether self examination actually results in a reduction in mortality rates, which is the overriding objective of all screening programs. Of course there is no physical harm in breast self examination, and yes, it is possible some cancers may be detected that a routine screening mammography may have missed, but in many cases, self examination leads to greatly increased psychological stress on the individual, and places unnecessary strain on medical resources.
About 8 out of every 10 lesions discovered by an individual by breast self examination turn out to be benign. There is no hard evidence really on which to conclude that BSE results in a breast cancer mortality rate reduction. Furthermore, women in there 40s should be undertaking a proper medical mammographic screening every year to 18 months anyway, which should detect any lesions and inform as to any further diagnostic followups, and treatments if necessary. Most breast cancers are in fact detected by women themselves, but the survival rate would be higher with regular, proper screening, so that the cancer is clinically detected before progressing to the point where a woman can detect it herself.
What is a breast self exam?
Basically, to perform a breast self exam the woman stands in front of a mirror with top exposed and looks for signs of swelling, soreness, or dimpling, in all parts of the breast. It is first done with hands resting on the hips, then with arms raised above the head. Then, breasts are felt with the fingers, pressing lightly at first to find surface abnormalilies, and then pressing more heavily to check for lumps within the deeper tissue. In addition, the woman should check the ‘axillary tail’ of each breast that leads toward the armpits. She should then again feel the breasts while lying down. The nipples should also be gently squeezed to check for any discharge.
It is of interest to note that the technique of breast self examination is generally not something which physicians instruct their patients to do, but it tends to be taught by medical ‘clinicians‘. Statistics tend to show both postive and negative results from breast self examination, but it is certainly no substitute for regular breast cancer screening beginning at an appropriate age. (about 40, or earlier if a women is in a known higher risk group) Visit this page for more information on women’s presenting complaints when they first inquire about possible breast cancer.
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- Baxter N, with the Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update : should women be routinely taught breast self-examination to screen for breast cancer? CJMA, June 26, 2001;164 (13).
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- Baxter N. Preventive health care, 2001 update: should women be routinely taught breast self-examination to screen for breast cancer?. CMAJ. 2001;164(13):18371846.
- Kosters JP, Gotzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev. 2003;(2)
- National Breast Cancer Foundation, Inc.. Breast self-exam (BSE). Available at: http://www.nationalbreastcancer.org/about-breast-cancer/breast-self-exam.aspx Accessed November 9, 2010.