Breast Self-Exams Useless?

Women have been advised for years to do regular breast self-exams to detect breast cancer at an early stage, the point at which the disease is considered most curable. But a new study by researchers at the Fred Hutchinson Cancer Research Center in Seattle suggests that such self-exams may be a waste of time.

In a study of 267,040 women employed in Shanghai textile factories, U.S. researchers and their Chinese counterparts gave intensive training on how to do a breast self-exam to half the participants, while the other half served as the control group, and received training on preventing back pain. Over a period of several years, researchers kept track of the number of women who developed breast cancer. Not surprisingly, the trained women detected about twice as many lumps as the women who had not been trained; however, nearly all the extra detection was of benign tumors. The trained women fared no better at finding malignant tumors than the controls, and the death rate from breast cancer was the same for both groups.

Although the study is still ongoing, and the data considered preliminary, the researchers were not optimistic about the value of breast self-exams.

In related news:

• A study at a leading Australian maternity hospital with a well-regarded scanning unit has found that about 40% of major fetal defects are not detected by routine ultrasound scans.
• Genetic testing to determine the likelihood of acquiring diseases such as breast cancer is now available, but it is raising many questions. Is the anxiety of knowing that one has a cancer gene and will probably get cancer less than the anxiety of not knowing one's fate? Can the testing results be kept confidential so people won't be fired from jobs or lose their insurance? On top of these concerns, scientists from the Johns Hopkins University School of Medicine have now found that almost one-third of physicians who order genetic testing for patients misinterpret the results. 

Based on information in: Science News, 3-29-97; New Scientist, 3-15-97 & 4-5-97; The New York Times, 3-26-97