How effective is breast self-examination?

Dear Doctor,

How often should I go for a breast cancer check-up? I feel like self-checking is not as effective.

Maria

Dear Maria,

Breast cancer is the most common cancer in women and second highest among prevalence of all cancers globally. If detected late, it may have spread to other parts of the body, causing much morbidity and mortality. Hence, the need for early detection is emphasised.

Self-examination of breasts was promoted as a measure for early detection of breast cancer, for the past several years. This involved visually examining and feeling the breasts by standing or sitting, with breasts straight. The lady was supposed to feel all quadrants of the breast, one by one in both breasts. On finding any suspicious lump or mass, it was subjected to further investigations, like mammography and biopsy. If needed, x-rays and scans of various body parts were taken to confirm or exclude any suspected spread of the tumour.

However, self-examination of breasts is no longer strongly recommended as before. Later, studies showed not much difference in morbidity and mortality by self-examination, or that done by a health care provider. Rather, it may be misleading. It is said that self-examination led to greater number of biopsies and other tests. It is not that self-checking is prohibited, but it is not considered as an effective measure as before.

The American college of Obstetricians and Gynaecologists (ACOG) recommends that women in their 20s and 30s have a health care provider perform a breast examination every one to three years and then once every year, after they turn 40. 

 Dr. Rachna  Pande is a specialist in internal medicine.

 

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