Local health-care providers still encourage women (and men) to perform breast self-exams
By Callie Lyons
September 2, 2008
For decades health-care professionals have been training women to perform monthly self-exams to detect early signs of breast cancer. But some experts are now discouraging self-exams in light of new research, which indicates they may provoke unnecessary anxiety and invasive testing.
Despite the new guidance, local doctors and nurses say they believe self-exams are still the best practice for women — and men — under the age of 40 in the absence of exceptional risk factors.
Two recent studies from the Cochrane Collaboration revealed that self-exams turn up a lot of false alarms – and result in a significant amount of nonessential biopsies. Further, they say there is no evidence that breast self-exams result in fewer cancer deaths. The independent trials were conducted in Russia and China.
Even so, the mammography unit at O’Bleness Memorial Hospital in Athens is still distributing literature on how to perform self-exams. Patients are encouraged to use that means of detecting abnormalities that may need further investigation. And many area health-care providers believe that is the best advice.
Lillian Collins, a registered nurse and section control coordinator for O’Bleness, said some of the problems with self-exams likely have to do with the way they are performed. For instance, women aren’t always sure what they’re supposed to be feeling.
“When they feel something different, women become more concerned than they need to be,” Collins said.
Also, self-exams don’t turn up every kind of breast cancer because not all forms of the cancer begin with a lump. Inflammatory breast cancer comes on like a rash or bug bites on the skin. For this reason, it is often treated initially with antibiotics, which wastes precious cancer-fighting time and delays appropriate treatment.
However, despite the new evidence against self-exams, Collins has a more personal take on the issue.
“My mother died of breast cancer. It is throughout my family,” Collins said. “If my sister was not checking monthly, I’m not sure she would have found the problem that she’s being treated for now.”
Collins said people with a history of cancer in their family or other risk factors are often advised to have mammograms every six months.
“But personally speaking, if we had waited six months, what we’re seeing with my sister would be a different story,” Collins said.
The American Cancer Society calls self-exams an option for women starting in their 20s with clinical breast exams about every three years. For women over 40, annual clinical breast exams and mammograms are recommended.
Collins said women under the age of 40 who have concerns, family histories of cancer or risk factors should pursue a mammogram with the assistance of a physician. Mammograms can detect problems and lumps that are too small to be felt. MRIs are another means of detecting breast abnormalities and cancer. While this method is being used more often, it’s also very expensive.
“Women should do breast exams, but not freak out over them, like if they miss a month or something,” Collins said. “I can’t honestly say I would want to encourage my female friends to stop (performing self breast exams).”
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