Are Breast Self-Exams Doing More Harm Than Good?
There’s no woman alive who hasn’t groped, squeezed or otherwise touched her own breasts. At one point, doctors even recommended this kind of hands-on self-exploration as a preventive tool for detecting breast cancer.
Now? Not so much. In the latest breast cancer screening guidelines, published by the American Cancer Society (ACS) in 2015, the organization upheld its recommendation against self-examinations for women who are at average risk for breast cancer.
The self-exam was traditionally recommended as a way to become more aware of how your breasts ordinarily look and feel, according to the Mayo Clinic. It was a way for women to take physical and visual inventory of any nipple weirdness or skin changes (like lumps, dimpling or pulling) in their breasts. But a self-exam is actually not a solid breast cancer detection strategy.
"Research has not shown improvement in mortality or early detection for the breast self-exam," said Crystal Fancher, M.D., a surgical breast oncologist at Margie Petersen Breast Center at Providence Saint John’s Health Center in Santa Monica, California. "There’s not enough evidence to support regular breast self-exams."
One scientific review, conducted by the Cochrane Library and updated in 2007, found that breast self-exams had no significant impact on breast cancer survival rates and may actually do more harm than good by causing needless concern and anxiety. Think about how freaked out you might feel waiting to get an appointment with your doc, sitting through invasive imaging tests and undergoing painful biopsies—especially considering that "less than 10 percent of women who are called back for more tests will be diagnosed with breast cancer," Fancher said.
If something doesn’t look or feel right, 'women should report any changes to their doctor ASAP.'
So it’s OK if the last time you thought about feeling yourself up for health purposes was after a high school sex ed class. Even though some cases of breast cancer are self-detected, self-exams don’t typically reveal cancer "that would not have otherwise been found through recommended screening or incidentally while dressing or showering," Fancher said.
That said, the ACS doesn’t completely dismiss the self-exam; rather, it says women who choose to do them should have their technique reviewed regularly by a doctor. And the National Breast Cancer Foundation still suggests women of all ages perform self-exams at least once a month. "Some women might still be more comfortable doing regular self-exams as a way to keep track of how their breasts look and feel," added Richard Reitherman, M.D., Ph.D., medical director of breast imaging at MemorialCare Breast Center in Fountain Valley, California.
Plus, the ACS recommendation is aimed at women with normal risk, Reitherman stressed. Women who have a personal or family history of cancer may want to see a doctor for clinical breast exams and counseling.
No matter your family history, remember that a self-exam, if you choose to do one, isn’t a substitute for your annual mammogram. Having a regular mammogram is the most effective way to reduce breast cancer-related deaths, said Reitherman. "Smaller cancers can be detected on mammography before they can ever be felt,” added Fancher.
The United States Preventive Services Task Force (USPSTF) recommends all women undergo a risk assessment for breast and ovarian cancer by age 30. This type of test can help a doctor determine whether they should begin mammograms or MRI screenings sooner than the recommended starting age of 50. And once risk is determined, your doctor may suggest a self-exam protocol.
The point is, you want to stay on top of what’s going on with your body. If something doesn’t look or feel right, "women should report any changes to their doctor ASAP," Fancher said.
"Every woman is the most competent person when it comes to knowing their own body," said Reitherman. So no one can be trusted more than you to make independent, personal decisions that affect your health—including whether or not you choose to get handsy with yourself.