Breast Self Exams May Offer False Hope The Canadian Cancer Society announces that women can forget about doing monthly breast self-examinations — they don't prevent breast cancer deaths and they give women a false sense of security if they find no lumps.
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Breast Self Exams May Offer False Hope

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Breast Self Exams May Offer False Hope

Breast Self Exams May Offer False Hope

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This is DAY TO DAY. I'm Alex Cohen.


And I'm Madeleine Brand.

In a few minutes, a new definition of traveling lightly. The airlines misplaced more than one million pieces of luggage this summer.

COHEN: But first, today is the first day of Breast Cancer Awareness Month. For years, the conventional wisdom has been that women should check their breasts for lumps and irregularities every month.

(Soundbite of ad)

Unidentified Woman #1: Experts agree, early detections starts with monthly home self-exams...

COHEN: That message came from the manufacturers of a kit that helps women do breast exams at home. But they might not be selling so many of them from now on - at least not in Canada. A few days ago, the Canadian Cancer Society announced it would no longer advise women to examine their breast monthly.

NPR's Karen Grigsby Bates reports.

KAREN GRIGSBY BATES: Once a month, a lot of women do this...

(Soundbite of water running)

BATES: At the recommendation of their doctors, while they're in the shower and soaped up, they examine their breast for suspicious lumps or changes. For about 30 years, it was accepted wisdom. But as additional study results became available, there's been some rethinking about that - at least in North America.

In 2003, the American Cancer Society decided studies didn't conclusively support that breast self-examinations, or BSCs, reduce the number of deaths from breast cancer. So it said it is, quote, "acceptable for women to choose not to do BSC or to do BSC irregularly." A few days ago, the Canadian Cancer Society suggested women do away with them completely.

The society's spokesperson, Heather Logan, explains why.

Ms. HEATHER LOGAN (Canadian Cancer Society): What's different about the recommendations today is that we're transitioning away from the very prescriptive, rigorous approach to breast self exam that has to be done in a very certain way at a very specific time of the month on a regular basis towards breast health awareness.

BATES: Logan says the society's doctors feel the benefits of BSCs aren't clear, whereas some of the drawbacks are. One is the tendency of some women to find every little change, even normal ones, alarming. That leads to additional tests and biopsies to make sure everything's okay. And some of those procedures are painful or have other side effects. And, says Logan, there's another drawback doctors find even more worrisome.

Ms. LOGAN: Also a feeling, a false sense of security, that if they've done a BSC, that they don't need to participate in an organized breast cancer screening program with a mammogram and a clinical breast exam.

BATES: Radiologist Dr. Rehana Kapadia is chief of mammography at Sinai-Grace Hospital, which is part of the Detroit Medical Center. Doctor Kapadia politely and firmly disagrees with the Canadian Cancer Society's latest decision.

Dr. REHANA KAPADIA (Sinai-Grace Hospital): In my opinion, breast self-examination is helpful, and women should do it.

BATES: Although both cancer societies say the life-saving properties of breast self exams are largely anecdotal, Dr. Kapadia is convinced that breast self exams do make a difference because she's had this experience several times.

Dr. KAPADIA: The patient comes with a palpable mass, we do a mammogram, and we may not see it.

BATES: But further tests may lead to a definitive answer.

Dr. KAPADIA: We can go ahead and biopsy it, and often it is malignant.

BATES: Kapadia and both North American cancer societies are on the same page about one thing: women shouldn't rely on their BSCs alone. Self exams are part of a whole breast health trio that includes a physical exam by a health care professional, a doctor or a nurse practitioner, and a mammogram.

And while doctors might be divided on the benefits, many women remain determined to do self-examinations anyway.

In a local shopping center, Erma Bolton(ph) and Jackie Horseford(ph) respond this way when asked if they do a monthly BSC.

Ms. ERMA BORTON: Yes, I do.

Ms. JACKIE HORSEFORD: You do need to do it.

BATES: And they're not alone. So organizations like Susan G. Komen for the Cure will continue to provide free exam how-to cards in several different languages for the asking and myriad online instructions to make sure that if women are going to do BSCs, they do them correctly.

(Soundbite of online recording)

Unidentified Woman #2: Use a mirror wide enough to see your whole chest. Check the...

BATES: The American Cancer Society believes this three-fold approach - self-exam, position exam, and mammogram, or ultrasound - may weave a tight enough safety net that many nascent cancers can be caught before radical treatment becomes necessary.

And even though the Canadian and American cancer societies feel that BSCs can be used optionally, if at all, anecdotes that featured cancers caught early at home may override the professionals' opinions.

Jackie Horseford has two friends who are glad they continued to check.

Ms. HORSEFORD: Each time by themselves they caught the lump; none of them on the mammogram.

BATES: So despite this latest announcement, many women will continue to check themselves monthly.

Karen Grigsby Bates, NPR News.

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