Study questions breast self-exams

By Neil Munshi, Globe Correspondent

Although most women are told to examine their breasts every month for lumps, new research confirms that the practice – on its own – may do more harm than good. Self exams, and those by healthcare providers, actually produce an increase in benign biopsies, but don’t get the patient into treatment earlier or save her life.

“At present, screening by self-examination or physical examination cannot be recommended,” the researchers wrote in today's issue of The Cochrane Library, in which they reviewed previous research on nearly 400,000 women.

Many cancer organizations changed their guidelines to reflect the original research after it was published five years ago, while maintaining that women should still be aware of what their breasts look and feel like, and to report any changes to their doctor.

“What this research does is [say] breast self exam by itself doesn’t increase survival and it never did,” said Cindy Geoghegan, executive advisor for scientific community relations at the Susan G. Komen for the Cure. “But as part of a comprehensive plan for women for early detection” that includes maintaining a healthy lifestyle and knowing your medical history, “we’re not going to say don’t do it.”

The study focuses on two studies – a 2003 study of over 120,000 Russian women and a 2002 study of over 266,000 Chinese women. While the Chinese study provides the stronger evidence – the Russian study was conducted amid the fall of the Soviet Union – both suggest that self-examination can actually pose potential harm in the form of increased benign biopsies, while no evidence can be found for potential benefits.

“Publications like this are very useful for informed decision making by women,” said Dr. Barry Kramer, associate director for disease prevention at the National Institutes of Health. “Sometimes the messages that are out there are not connected to the literature and women and physicians themselves may not be fully aware of these results.”

The study does not suggest that women should not perform the exams themselves, or have medical professionals perform them, but the authors write, “that the lack of supporting evidence from the two major studies should be discussed with these women to enable them to make an informed decision.”