As of yesterday, the Canadian Cancer Society is no longer recommending routine self breast examinations as a reliable way to detect breast cancer. Heather Logan, director of Cancer Control Policy and Information for the Canadian Cancer Society stated that mammography and clinical breast examinations done by a doctor are now recommended instead of monthly self exams:
“There is no evidence that doing a rigorous, systematic BSE will lower breast cancer death rates. The general transition is toward general breast health awareness where you are aware of normal breast tissue, the feel and look, and you can detect changes and report them to your doctor,” Logan said.
Taking one look at the comments section of the CTV.ca news posting on this story will give you an idea of how mixed the reaction has been to this development. Many women are shocked that after years of being encouraged to do monthly BSEs the new message is “never mind.” The issue is complex. This from the Vancouver Sun:
Logan said evidence now shows that technique may have resulted in more harm than good, in that many women reported feeling guilty or stressed by not sticking to the exact schedule, or missing monthly exams.
The technique also may have given women a false sense of security that kept them from having mammograms or a clinical exam by a professional health care worker.
“That’s definitely not the message we need to be sending women,” Logan said.
Many women are coming forward to state that they discovered their own breast cancer by doing a BSE and that they believe their cancer would not have been detected soon enough without the monthy self-exam.
I’m curious to know what readers think about the sudden message shift and if you think that this is a positive step in women’s health or that it could instead put more women at risk?
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six comments
Wow. That's definitely startling - though I also feel like every few years something like this comes up, where the SOGC or something says "don't check your breasts anymore!" and then says "oh wait! we were just kidding! keep checking them!"
I definitely fall into the category of women who feel guilty and stressed because I always forget to do the exam. However, the amount of stress it causes me isn't that large (like on the 7th day of my cycle I think, "oh drat. I am the wurst" and then I forget about it). It almost seems kind of silly to suggest that as a reason to stop telling women to do breast exams - I can't imagine that large numbers of women have more than fleeting guilt about it.
Why don't they just tell women to both get checked up by doctor, and keep checking themselves? Sometimes it seems like the biomedical community is in such a hurry to find the answer that they don't realise there could be many answers.
Posted by Thea
September 27, 2007, 10:03 AM
I heard this on the radio last night and was a bit stunned - after seeing the pamphlets describing how to self-examine in friends' and relatives' bathrooms for years, it's pretty sad to hear that all this vigilance and sharing of information in the name of women's health is now considered bunk.
Nevertheless, I do think that self-exams, at least the way they're taught now, are not entirely useful. Mostly I think it has to do with how women (or maybe just me?) conceptualize our breasts - I guess up until a certain age I imagined breasts were like water balloons - all smooth and uniform. But they're not! They're full of tissue, which can feel lumpy or strange if you're not used to it. So when I found a lump, what ensued was several days of total panic, crying, writing my will, etc., followed by a doctor telling me they were undoubtedly fibroidenomas (which are also known as "breast mice" because they're soft and move around. Isn't that nice?), which are benign lumps that many women have.
Now, no one ever told me about fibroidenomas - if I had known, it would at least have saved me several nights' sleep and some very tedious trips to the hospital for ultrasounds. Since then I've totally given up on self-exams, as I don't think I can tell a good lump from a bad. Maybe breast exams should be part of health curriculum in schools, and women can be taught to suss out which lumps are potentially dangerous and which are just naturally part of the wonderful world that is having bazooms.
But that's just my experience.
Posted by Anna
September 27, 2007, 10:09 AM
Anna - at the school I went to (an all-girls Catholic school in Singapore) we did get taught breast self-exams at school! It was the most hilarious thing: the nurses brough in this suitcase, and when they opened it up it was a pair of rubber breasts (no joke!) glued to the inside of the suitcase. And there were both benign and unbenign lumps to help us tell them apart.
At the same time, because I was hopeless at telling the real and fake lumps apart, I got discouraged and never did exams on my own. However, I think the point is that if you do the exams regularly you get used to what's normal and what's not normal for your boobies.
Also: breast mice?? I like soft things that move, where can I get some?
Posted by Thea
September 27, 2007, 10:32 AM
Thea, your school has officially blown my mind.
I do believe that any practice that makes you more aware of your body and its particularities is bound to be good and should probably not be abandoned because of the latest current in healthcare. I just think more needs to be done to teach women about the specificities of breasts - as I learned, it's way more complicated than lump = bad, no lump = good.
Posted by Anna
September 27, 2007, 10:53 AM
I have a breast mouse. I call him 'lumpy'. I could also call him lazy because he's an atypical breast mouse in that he just sits there, not moving, and freaking me out during my first ever self-exam. (I think I've shared this before, but hey, I'm feeling repetitive :) ).
First breast exam and you find a hard, not-mobile lump that is only on one side? That'll give you the cold sweats. Not breathing for a few days (there is breast cancer in my family, in all the ominous places), I went and got it checked out. And after feeling it, sending me to get it felt by someone else, and then doing a fine-needle aspiration, they concluded that it was in fact... wait for it... nothing. Or more specifically, a fibroidenoma. (Me too Anna, me too).
I now am supposed to go back once a year and get it poked at professionally. Which was especially fun the year the intern was there, doing the exam on her own while the doctor did something more important. Funtastic when she froze mid-exam, went totally ash-faced, and left in a hurry to fetch the doctor. Who came in to explain to her that boobs are in fact, not much like water balloons at all, and the lumps she felt were perfectly normal. Maybe UofT med school needs that briefcase shipped from Singapore...
Posted by Catherine
October 1, 2007, 10:13 PM
I call mine Cheryl.
Posted by Anna
October 2, 2007, 1:04 AM
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