Caledonia Argus

Breast self exams still important

Posted: 10/15/02

by Jane Palen
Managing editor

October, which has been designated as Breast Cancer Awareness Month, began this year with some surprising news. The monthly breast self-exam (BSE) that health care professionals have been promoting for years seemed suddenly to fall out of favor following publication of a study that showed no statistical difference in breast cancer mortality rates in women who practiced BSE than in those who did not. The study, published in the Journal of the National Cancer Institute, was conducted on 266,000 women in Shanghai, China.

Currently, about 400,000 cases of breast cancer are diagnosed in the U.S. each year, and about 20,000 women die each year from the disease.

Despite the news, some health care professionals are not ready to tell women to quit BSE.

Deb Miller, CMN, MS, C-FNP, a Franciscan-Skemp family nurse practitioner at the Caledonia Clinic, said she still believes that monthly self-exams have value.

From a public health perspective, said Miller, the results of the study were indicating that if BSE was not going to save lives, then it was not worth the effort to teach women to do them.

ìIt doesnít mean that BSE is not an important part of breast care when diligent women perform it monthly,î said Miller. ìWeíre not telling women to stop. I still think it has value.î

Miller warned against trying to extrapolate too much from one study, but noted that the emphasis may be shifting from BSE to the exam the health care professional does during the annual physical and mammograms after the age of 40. The Chinese women who were studied had no access to mammograms. The conclusion of the study was that teaching BSE to women is not a good use of limited funds in developing countries because it seems to make no difference in the mortality rates.

In the US, women have more opportunities to detect breast cancer, and BSE can be important. And the better women get at BSE, the more helpful it is, said Miller. Most health care professionals would agree that a highly motivated woman performing BSE correctly is making a positive choice for her health.

ìRight now, itís the best thing we have,î noted Miller. Any woman who finds a lump in a breast should call the clinic right away and can even be seen the same day, said Miller.

There may be other diagnostic tools available soon to help in the fight against breast cancer. MRIs and ultrasound are two methods that may be refined for wider use in diagnosing breast cancer, said Miller. Another tool being researched is ductal lavage, which is like a pap smear for the breasts. A sample is taken from the milk glands of the breasts and tested for abnormalities that could point to cancer.

Women should learn how to perform a self-examination properly and be on the lookout for a lump, dimpling of the breast or a nipple discharge. The underarm area should be checked for lumps as well.

Miller said she knows of women who have found lumps on their own between their annual visits to the clinic, and those lumps have turned out to be cancer. For that reason, when it comes to breast self-exams, Millerís advice to women is ìPlease keep doing it.î

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