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?