Breast self-examination

Article Abstract:

Although there is considerable advocacy for breast self-examination, there are complex issues surrounding self-examination, and few studies have indicated clear-cut benefits. The skills required for self-examination are not easily mastered or effortlessly performed, and the objective evaluation of success is difficult. Furthermore, some studies confuse the issue by analyzing the ability of breast self-exam to diagnose breast cancer. The purpose of self-examination is to detect changes in the breast, which are then reported to a physician or expert practitioner. The analysis of self-examination should be evaluated on this basis. Studies looking for an actual effect of self-examination on mortality have found little, most likely because any effect of self-exam may be overshadowed when other screening methods are also available. Furthermore, some studies have hinted at a negative effect due to possible false reassurance. A woman might delay self-referral to a physician based on her own examination, but studies on this potential problem have produced conflicting results. Despite the fact that the medical benefits of breast self-examination remain questionable, and women themselves are ambivalent about the process, those who desire to include self-examination in their own health care should be able to receive good instruction from a program which provides reinforcement and feedback. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Self-examination, Medical, Self examination (Medical)

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Changes in breast self-examination behavior achieved by 89, 835 participants in the Canadian National Breast Screening study

Article Abstract:

Participants in the National Breast Screening Study (NBSS) were assessed for breast self-examination (BSE) behavior. Among 89,835 participants, 64,619 were eligible for repeat screening each year, and 25,216 subjects were followed by mail after one screening examination. The BSE competence scores, which were based on seven BSE criteria, improved for subjects eligible for rescreening, and were related to the reported BSE frequencies of breast self-examinations. The number of participants who reported breast self-examination 12 or more times per year increased from 20 percent at the beginning of the study to between 50 and 64 percent at the end of the study. Reports of complete lack of breast self-examination (zero frequency) decreased from 50 percent to between 10 and 15 percent. Educational status, age, eligibility for mammography (X-ray of the breast), smoking history, and ethnic origin did not influence breast self-examination behavior. However, a family history of breast cancer did affect BSE scores. Results from the study show that women who enter screening programs will improve their breast self-examination skills after receiving short-term, repetitive instruction on breast self-examination. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The importance of clinical breast examination

Article Abstract:

The emphasis on mammography as an effective early screening technique for breast cancer has sometimes overshadowed the importance and effectiveness of the clinical examination. Nevertheless, physical examination is the most common early detection method employed by physicians for any cancer. The experience and skill of the examiner is of primary importance, but cancers as small as 2 to 3 millimeters may be detected. Some studies have indicated that the mammogram may have a false negative rate as high as 45 percent, and in about half of these cases the patient will delay further evaluation. It is clear that the mammogram should be a supplement to the physical exam rather than a replacement for it. Furthermore, all undiagnosed, persistent masses identified by palpation must be biopsied, regardless of mammographic findings. The final diagnosis of breast cancer always lies in the hands of the pathologist. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mammography

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