"Belinda Stronach is the latest in a long line of women who say breast self-exams saved their lives by catching their cancer early," writes Rebecca Dube in Should I be checking my breasts?.
"There's only one problem with that inspirational story: Breast self-exams don't work.
"According to several long-term studies, including a 10-year study of 267,000 women, there is absolutely no difference in survival rates between women who perform regular self-exams and those who don't."
To help shed light on this important issue, Dr. Nancy Baxter, assistant professor of surgery at the University of Toronto, and Diana Ermel, president of the Canadian Breast Cancer Network, agreed to answer questions on this issue earlier this week.
Top, Dr. Nancy Baxter; bottom, Diana Ermel
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Your questions and their answers are available at the bottom of this page.
Dr. Baxter is an Assistant Professor of Surgery at the Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto. During her surgical training she completed the Surgeon Scientist Program, specializing in clinical research, and published guidelines for the Canadian Taskforce on Preventive Health Care regarding the routine use of breast-self examination for prevention of deaths from breast cancer. She is an active health services researcher focusing on cancer screening and survivorship issues for cancer patients. She holds grants and awards from the Canadian Institutes of Health Research, the American Society of Clinical Oncology, the Lance Armstrong Foundation, and the Ontario Ministry of Research and Innovation, and has over 40 peer-reviewed publications.
Diana Ermel, of Regina, SK, is the president of the Canadian Breast Cancer Network, a survivor-directed national network of over 225 partner and member groups and hundreds of individuals. The Network is a national link between all groups and individuals concerned about breast cancer, and represents the concerns of all Canadians affected by breast cancer and those at risk. Ms. Ermel discovered her tumour while doing breast self-exam and has been breast cancer free for 14 years. She is a registered nurse and has recently retired from a career as a faculty member of the Nursing Education Program of Saskatchewan. Ms. Ermel is also a member of the Canadian Breast Cancer Research Alliance Board and the Breast Cancer Care Steering Committee of the Saskatchewan Health Quality Control Council; past Board member of the Saskatchewan Cancer Agency; founding member of the Saskatchewan Cancer Advocacy Network; past president of Breast Cancer Action Saskatchewan, among others. She continues to be involved in many other breast cancer, cancer and health related initiatives in Saskatchewan and Canada.
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Mausumi Banerjee, Canada: For women under 50 who are not screened with mammograms, how would breast cancer be otherwise detected if self-exams are not done either?
Also, I feel a lot of anxiety in the day or two leading up to doing a self-examination and while I am doing it. While I am doing it, I am never exactly sure what I am looking for (even though doctors have explained it to me and I've read about it) and if what I am feeling is normal or not. This just causes more anxiety. Do you have any suggestions for me? Thanks
Nancy Baxter: Hi Mausumi. You bring up a really important point. Many women find their own breast cancers, however, usually this is during what I term "casual palpation" (during showering, changing, or sexual relations), not during breast-self examination and interestingly this is true even for women who regularly perform breast self-examination. Casual palpation and breast self-examination are very different things -- breast self-examination is a systematic, rigorous, and regular method of examining the breasts. It is a technique that requires instruction, training and reinforcement while casual palpation does not. If a woman finds a breast lump that is concerning she should report this to her doctor, irrespective of how it is found.
Your feelings of anxiety about breast self-examination are shared by many women. Breast self-examination is not for everyone. Discuss your anxieties with your doctor and remember, routine breast self-examination has never been shown to be effective in the scientific studies, so this technique may just not be right for you.
