Studies found that a breast self-exam (BSE) can be an important way to find cancer in young women, especially young woman with a higher-than-average risk of developing breast cancer. The results offer another point of view in the ongoing discussion about the role of BSE in breast cancer screening.
For years monthly BSE was part of an overall breast cancer screening plan for women of all ages. A suspicious area found by BSE led to many breast cancer diagnoses and successful treatments. BSE, along with regular exams by your doctor and an annual mammogram starting at age 40, can help make sure that any breast cancer is diagnosed early, when it's most treatable. Still, screening tests aren't perfect. Both BSE and mammograms can result in what's called a false positive. A false positive is a suspicious result that looks like cancer but really isn't. Besides the fear of a breast cancer diagnosis, a false positive usually means more tests (including biopsies) and follow-up doctor visits. The process can be very stressful and upsetting.
Some doctors started questioning the usefulness of BSE after research showed that regular BSE doesn't reduce the number of women who die from breast cancer. Because it costs money to promote BSE, many public health professionals thought that the money could be better spent on something else that would have more of an impact on breast cancer's affect on society. These concerns caused the American Cancer Society (ACS) to change its BSE guidelines several years ago. The ACS now views BSE as an optional -- not a recommended -- screening technique. Still, if you or someone you know was diagnosed and treated for breast cancer because of something found during BSE, you probably think BSE is very valuable. Any woman who wants to do everything she can to monitor her breast health should do BSE.
In one study, 147 young women at high risk for developing breast cancer took part in a program that offered BSE training and a physical breast exam by a doctor two to three times per year. The women also had a breast MRI each year. MRI is often used instead of or in addition to mammograms to screen for breast cancer in young, high-risk women. Some of the women also had mammograms.
During 3 years of follow-up:
- 24 women found a lump during BSE; six lumps were diagnosed as breast cancer
- 23 women had a breast abnormality show up on the MRI; six abnormalities were diagnosed as breast cancer
- Eight women had an abnormality show up on a mammogram; two abnormalities were diagnosed as breast cancer
BSE was clearly an important screening technique for these young high-risk women. Over 3 years, six of the 14 high-risk young women (43%) diagnosed with breast cancer were diagnosed because of something found during BSE.
In another study, researchers looked at the records of 628 women 40 or younger who had been diagnosed with breast cancer. Most of the young women weren't considered high-risk before their diagnoses, so they didn't have an intensive screening plan. And because mammograms aren't recommended for women younger than 40, most of these women hadn't had a mammogram before they were diagnosed.
The researchers looked at how the women were diagnosed with breast cancer:
- 71% were diagnosed because of BSE
- 24% were diagnosed because of a mammogram
- 3% were diagnosed because of a doctor's physical breast exam
Because these women weren't getting regular mammograms yet, BSE was the most likely way for breast cancer to be diagnosed.
All healthcare decisions, including BSE, are personal choices based on the information available and each person's unique situation. A woman can choose to make regular BSE part of her breast health monitoring and cancer screening plan. In many cases, official recommendations and guidelines can affect whether insurance companies cover a screening technique. But this isn't true for BSE, which requires only your time and commitment.
No matter how old you are, ask your doctor about the pros and cons of BSE and whether BSE should be part of your breast cancer screening plan. Together you can decide what makes the most sense for you. If you're younger than 40, this research suggests that doing BSE regularly is a good idea, no matter what your breast cancer risk is. If you're older than 40, it's important to have a mammogram every year, whether or not you choose to do BSE.
Visit the Breastcancer.org Breast Self-Exam page to learn how to do BSE.
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