Second thoughts on breast self-exams
Posted on July 28th, 2008 – 12:03 PMBy Maura Lerner
Some readers are fuming about my Sunday story about a change of heart on the importance of monthly self-exams for breast cancer.
Mammogram of breast with cancer (see white spot)
In the last few years, cancer experts have backed away from recommending self-exams, saying they don’t save lives, and create unnecessary tests and anxiety for many women. But if you read the comments, you’ll find why many women are outraged; they can testify that self-exams saved their lives, or the lives of someone they love.
Many seem to think that doctors are telling women to ignore lumps. Not so.
They still say women should notify their doctors IMMEDIATELY if they find something unusual, such as a lump or change in their breast tissue.
The question is, how do you find them if you don’t do monthly exams?
Doctors know it seems contradictory: watch for changes, but don’t worry about monthly exams.
“I think it can be confusing,” admits Carol Bergen, clinical manager of the Piper Breast Center at Abbott Northwestern Hospital in Minneapolis. Like many in the field, Bergen, a nurse, still believes there’s a place for self exams, but that mammograms and exams by trained clinicians are the top priority. “Breast self-exam is important as well, but we’re emphasizing it a little less,” she said. “If you’re going to let one lapse don’t let (it be) mammography or the clinical breast exam.”
Dr. Amy Spomer, an oncologist at Park Nicollet Cancer Center, is also reluctant to drop self exams, even if statistically speaking they appear ineffective. “Not all breast cancers are detected by exam or even by mammography,” she said. “So even if there’s one or two people out there in the Twin Cities who noticed a change in their breast (that turns out to be cancer) and they get treated, I think it’s worth it.”
3 Responses to "Second thoughts on breast self-exams"
Don’t rely totally on technology. I had my yearly mammogram (digital) in March …no change I was told…although I knew I had a lump. I insisted on being seen, and in June (3 months later) I was diagnosed at Stage IV and given 12 mos to live it had already spread to my liver and lymph system). Women need be familiar with their bodies and make decisions based on changes that occur.
Unfortunately, many women ignore changes in their breasts. Thank you, Maura, for putting an all-caps emphasis on the fact that a woman who notices differences in a breast should see see a physician immediately. My cousin went straight to her doc when swelling suddenly developed. It turned out to be inflammatory breast cancer –the most uncommon form and one not detectable via mammograms. Because of its rarity, less is understood about IBC and the volume of research doesn’t come close to that pertaining to the more common breast cancers. We’re endlessly grateful that our beloved family member took quick action — and she had a tremendous oncology doc. She’s done a lot of public service work to help raise awareness about IBC. It is a tough and aggressive enemy but it’s been four years and she remains cancer-free — hallelujah!
The first I saw of this story was on the NBC evening news. Their medical reporter reported the findings, and I was pleased when Brian Williams replied after the story, pointing out that women everywhere have anecdotal accounts of a self exam saving their life. The medical reported clarified that they are not so much telling women to not do self exams, or to stop doing them, but that money shouldn’t be spent on campaigns promoting them. That money would be better spent promoting mammograms.
My mother died at the age of 45, from IBC. Like Allison stated above, this is almost always found by noticing a change in the breast tissue, NOT by mammography. My Mother’s regular mammogram 10 months prior to her diagnosis showed no indication of an irregularity, and she found her lump/tissue change while doing an exam in the shower.
As a woman, how are you supposed to notice a change if you do not know the normal state of your breasts? I will continue to do my own BSE’s, and I will continue to talk about my Mother’s experience and encourage other women to do their BSE’s in addition to having regular exams by their Doc and regularly scheduled mammograms.
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