“Breast self-examinations are no longer recommended.”
When I saw that headline earlier this year, I thought it was a typo. As someone who found my own breast cancer lump that turned out to be stage 3 cancer, I was surprised to learn that many health organizations like the American Cancer Society and the National Cancer Institute do not recommend breast self-examinations. And they haven’t done it for years.
So what happened?
Breast self-examination was created in the 1950s as a convenient, low-cost way for people to detect breast cancer in its early stages, when it is most treatable. But in the 2000s, investigation found that performing formal breast self-examinations (raising your arms, lying down, using circular motions, etc.) may not reduce the risk of dying from breast cancer. One meta-analysis Comparing women who did routine breast self-examinations with those who did not, it was found that there were no differences in their breast cancer survival rates. But people who performed self-exams had more false positives and almost twice as many cancer-free breast biopsies.
Read: What you need to know about a breast biopsy >>
Without data showing that breast self-examinations can reduce the risk of dying from breast cancer (and the potential for harm from unnecessary testing), most professional organizations and healthcare providers no longer recommend breast self-examinations for average risk people. (Average risk means you have no personal or family history or genetic mutations, such as BRCA 1 or BRCA 2)
Larry Norton, MD, a breast medical oncologist at Sloan Kettering Cancer Center, said the guideline’s move away from formal breast self-examinations doesn’t mean you should stop paying attention to your breasts. It’s called breast self-awareness.
What is breast self-awareness?
Breast self-awareness involves becoming familiar with how your breasts look and feel so you can identify any changes. “Lack of awareness of what is healthy in the body can prevent you from identifying something that is not quite right,” Norton said. “It’s really nice to know that there’s something different about your body, and it’s really nice when you find something different, no matter what it is, to draw attention to it.”
Unlike breast self-examinations, there is no schedule or technique for breast self-knowledge; It’s basically using your eyes and hands to figure out what’s normal for you. Signs of breast cancer to look for may include:
- lumps
- Pain
- Dimples in the skin
- Nipple discharge or bleeding.
- Redness or heat
- Swelling/size changes
Norton said changes in nipple appearance and discharge are more obvious, but knowing how your breasts feel is important because you may be able to detect signs of breast cancer that your provider or their imaging missed. “When you touch your breast and you feel an unusually hard spot or an unusual spot that hurts but didn’t hurt before, those are the things that are a little more subtle,” Norton said.
Timing and risks of breast self-examination
Although most healthcare providers recommend breast self-examination instead of formal breast self-examinations, some people may still want to stick with the standard technique and routine. If you do breast self-exams, it’s best to do them three to five days after your period ends, when your breasts are least tender or lumpy. If you are postmenopausal, do the self-exam at the same time every month.
Read: How to do a breast self-exam >>
Risks associated with formal breast self-examinations include false positives and unnecessary biopsies of tissue that is not cancerous. Researchers say the mental and financial stress of imaging and biopsies is also part of the reasoning against formal breast self-examinations. However, it is important to note that false positive results are common and the chances of getting a false positive result increase as you age. Concern about false positives shouldn’t stop you from paying attention to your breast health and contacting your healthcare provider if you see or feel anything unusual for you.
Norton said becoming familiar with your breasts to notice changes is the bottom line for self-exams. But neither breast self-awareness nor self-exams replace mammograms when it comes to detecting breast cancer.
Read: A mammogram saved my life >>
When to get a mammogram
Today, mammograms are the gold standard for breast cancer detection. According to the latest guidelines According to the U.S. Preventive Services Task Force (USPSTF), people who are at average risk should start getting mammograms at age 40, not age 50 as previously recommended. The change reflects recent data showing that 1 in 6 new breast cancers develop in people in their 40s and aligns with other organizations that offer screening guidelines.
Recommendations for how often to get tested vary from organization to organization: some say every year and others every one or two years. You should talk to your healthcare provider about what makes sense for your circumstances.
Regardless of the guidelines, Norton said if you feel or see anything suspicious, contact your healthcare provider immediately. “I like to say that your body has been entrusted to you and you should do the things necessary to honor that trust, and one of them is screening and the other is just knowing your body. “So when something is abnormal, you don’t ignore it.”
This educational resource was created with the support of Daiichi Sankyo and Merck.
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