Thursday, March 05, 2009

Is Breast Self-Exam Best?

Many of my patients have come in lately 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.

Do you perform regular self-exams?

1 comment:

JTWilliams said...

Yes I do my monthly exams and unfortunately at 41, I have had 2 lumpectomies and never found either tumor (one mass was found on an MRI and never felt by the surgeon either). It is very important for your dr. to do a good exam. If he/she doesn't, it is time to insist. Also this is yet another reason to not miss your annual appointment or mammogram.