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Self-Examination…Re-examined?

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Medical researchers at the Cochrane Collaboration, an international not-for-profit organization, have gone against traditional medical conventions by recently releasing a study claiming to contradict the positive benefits of breast self-examination.

The report, which points to possible negative effects stemming from the practice, stated, “Considering the currently available evidence, promotion of breast self-examination as a single screening method cannot be recommended.” This conclusion was reached after scientific studies conducted with more than 400,000 Russian and Chinese women determined that the exams did not decrease death rates for breast cancer patients; it simply increased the number of tissue biopsies that came back as negative for cancer.

Researchers claim the study confirms an earlier one conducted in 2003 and has recently led to some high-profile organizations changing their stance on the issue. Susan G. Komen for the Cure—the largest international organization dedicated to fighting breast cancer—stopped stressing self-examinations as being a frontline strategy to detect the disease. The American Cancer Society now calls the practice “an option”—a large change from its previous position of asking all women over age 40 to follow a monthly regimen of self-examinations to protect against breast cancer.

While these groups are not calling for a cessation of self-exams, the conclusions reached by the Cochrane Collaboration confirm the increase of biopsies being performed, which themselves may lead to results suggested to be detrimental to women’s health.

In addition, self-examinations increase the likelihood of discovering lumps, which are often benign.

In November 2002, Linda Janusek (RN, PhD, professor at Loyola University’s Niehoff School of Nursing) released a report to the U.S. Army medical staff that linked stress to having a breast tissue biopsy. Mounting stress weakened the immune systems of women who had detected lumps through self-examination and subsequently weighed the decision of whether to have a biopsy. Of those who went forward with the procedure, their immune systems did not return to prior levels. On the other hand, the weakened immune systems of those who did not have biopsies grew stronger.

With the report reinforcing previous findings negating the usefulness of self-examinations, there are still those who stand by the value of this practice.

Dr. Marissa Weiss, founder of BreastCancer.org, stated that 15% to 20% of all breast cancer cases are detected by a physical examination. Dr. Weiss further commented that, outside of her statistical data, “I can tell you that I have patients—plenty of them—who were the ones to find their breast cancer [through self examination] and it was found early and they are living and doing well.”

One such survivor is Good Morning America anchor Robin Roberts, who said in 2007 that she found a lump during a self-examination, which turned out to be breast cancer (CBS News).

Regarding women regularly examining themselves, Dr. Weiss stated that “we women are willing to take a risk and so if you ask a woman, she’s not going to see that it’s harmful.”

In deciding whether a woman should or should not regularly practice self-exams, including possible risks, information concerning breast cancer is widely available to make informed decisions.


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