The Burning Question: Are Breast Self-Exams a Waste of Time?


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The controversy
For years, breast self-exams (BSEs) were a staple of breast cancer screening and a crucial element in breast cancer awareness campaigns. But lately, many weighty organizations—including the American Cancer Society and the National Institutes of Health—have stopped emphasizing the importance of them. Nevertheless, some OB/GYNs are still telling women to do a formal BSE. So should you bother?

What the experts say
Research suggests that doing a formal, in-depth BSE on a regular basis wont actually improve your chances of beating breast cancer. In the largest and best-conducted study, which followed nearly 300,000 Chinese women over 12 years, those who were trained in BSE technique did not find any more breast cancers than those who were not. There was also a virtually identical number of breast-cancer deaths in the two groups. "The China study showed that it doesnt make any difference if you find a tumor by doing a regular, formal BSE instead of finding it incidentally—like when you roll over in bed," says Susan Love, MD, clinical professor of surgery at the David Geffen School of Medicine at UCLA and president of the Dr. Susan Love Breast Cancer Foundation. "Your chances of survival are dictated by the biology of the tumor—how fast- or slow-moving the cancer is—and not by how aggressively you check your breasts."

Doctors who still believe in doing self-exams say its an important part of early detection, especially for women who cant afford mammograms. "For people who dont have access to care, BSE is better than nothing," says Marisa C. Weiss, MD, president and founder of Breastcancer.org, who recommends that her patients do a comprehensive BSE once a month or every other month. The problem is, theres also a downside to doing these monthly self-exams. Studies find that women who perform them are more likely to run to the doctor with false alarms.

"If anything, doing formal BSEs can actually increase anxiety," Dr. Love says. Those who do BSEs also get more breast biopsies, which are costly, painful, and have been shown not to increase rates of detection or survival. In fact, about 80 percent of breast biopsies turn out not to be cancer.

The bottom line
Doing a formal self-exam isnt necessary. That said, you do need to pay attention to any changes you feel or see in your breasts, such as unusual lumps, swelling, irritation, dimpling, or pain in the breast or nipple. Also crucial: Dont skip your regular mammogram, which can find tumors that your hands cant feel.


Last Updated: September 15, 2011

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