Breast Self Examination…. are you confused?
For years women have been told that responsible self help aimed at reducing deaths from breast cancer, involved a monthly self examination of breasts (BSE). The procedure involved a structured process of looking at and then feeling every centimetre of breast tissue.
In truth, very few of the women I have come across in my practice have ever done a regular BSE, content with a quick soapy once over in the shower, or a sideways glance in the bathroom mirror. For these “guilty” majority, the latest news on BSE comes as a welcome relief.
The new edict from on high, dispenses with BSE, based on two studies involving 400,000 Chinese and Russian women. The Cochrane Collaboration says there is no evidence that self examination of breasts actually reduces breast cancer deaths. In fact, more than suggesting that BSE is a waste of time, the findings show that regular BSE can actually cause more harm than good for women. Self checking of breasts results in far more benign (harmless) lesions, with a resulting increase in breast biopsies to investigate them.
So does this mean that women should ignore their breasts and hope for the best?
Emphatically, NO!
In place of the arduous, and rarely practiced BSE, we are encouraged to practice “Breast Self Awareness” (BSA). No training required, BSA just means knowing your own body. Becoming tuned in to what looks and feels like your normal healthy breast. When you become familiar with touching yourself with awareness, during showering or bathing, and you get used to looking at your breasts in the mirror, you’re better placed to notice any kind of subtle variation from the norm.
You may be wondering just what an “abnormal” breast may look or feel like? There are a number of things to keep an eye out for. If you do notice any of these changes, see your doctor straight away. They may well be benign (non-cancerous) changes, but it’s always better to be safe than sorry.
*a lump or mass in the breast
*enlarged lymph nodes in the armpit
*changes in the breast size, shape, skin texture or colour
*dimpling or puckering of the breast skin
*nipple changes or discharge
*scaliness
*nipple pulling to one side or change in direction.
The risk vs benefit of either BSE or BSA varies with age according to Dr David Thomas, a breast cancer epidemiologist from the Fred Hutchinson Cancer Research Centre (Seattle). Women in their 20’s and 30’s rarely get breast cancer, but they are more prone to benign hormonal breasts lumps. For these women, according to Hutchinson, BSE or BSA can lead to more biopsies and interventions for non-cancerous breast lumps.
With increasing age however, a woman’s risk of breast cancer rises, and the incidence of benign lumps associated with the menstrual cycle, decreases. Says Hutchinson, “When women are in their 40’s it’s a good time for them to become more aware of their breasts and more aware of the changes that might be due to breast cancer…. it’s kind of controversial as to whether it’s worth the screening – either BSEs or mammograms – but they can do both if they want”.
Personally, I have had so many patients and friends who have detected their own cancerous breast lumps, through self awareness, I think that women of any age need to know their breasts intimately.
Lynda Wharton is a health researcher, writer and natural health practitioner with a special interest in women’s health. She is the author of three women’s health books including “Wellbeing” by Harper Collins.
More at www.lyndawharton.com