Breast self-exams can help diagnose some cases earlier, but they have not been proved capable of increasing the long-term cure rate in the context of research protocols. What’s more, there is concern that, when women are encouraged to do self-exams, they may be less likely to go in for early diagnosis mammograms, because self-exams can give them a false sense of security. Though there’s no proof of this either, the fact is that many health recommendations have started leaving out breast self-exams.
However, the findings of epidemiological and interventional studies do not always mirror the exact conditions of real life. As a point in fact, over the last decade cases of breast cancer in women under age 40 or 50 have increased sharply; this is the kind of breast cancer most closely related with heredity. The 40- to 50-year age group is not included in early diagnosis programmes that rely on regular mammograms. Although it would be best if these women were checked yearly by their gynaecologists using an appropriate technique, the truth is that a good many routine gynaecological check-ups consist only in a Pap smear, without any breast examination at all. Furthermore, any oncologist will acknowledge that cases of breast cancer diagnosed because the woman herself found a lump between one mammogram and the next are hardly the exception.
It's in this context where my personal opinion is in favour of continuing to teach women about the option of breast self-exams, insisting most emphatically that, just because you do self-exams, that’s no reason to skip your yearly gynaecological check-up or regular mammograms. Quite the opposite.
In my point of view, although epidemiological studies have failed to prove that breast self-exams improve tumour survival rates, there isn’t any evidence that they’re harmful, either, and they may be beneficial in the context of daily clinical practice by diagnosing tumours in young women and between mammograms a bit earlier.
Dr. Ricardo Cubedo, physician in charge of Hereditary Cancer, MD Anderson Madrid