For many years, we women were told to examine our breasts at least monthly to check for signs of breast cancer. In medical school, my fellow students and I learned how to teach our patients to examine their breasts. It’s a multi-step process that takes several minutes – checking your breasts in the shower, in the mirror, lying on your back (maybe you’ve seen diagram-heavy brochures -- still a staple in many college and community health centers). But in recent years, some medical organizations have done an about-face and now recommend against breast self-examinations; others say they’re okay to do, but not mandatory. Confused? Have questions? You’re not alone!
Why Did the Recommendations Change? In 2009, the United States Preventive Task Force (USPTF) published a recommendation against teaching breast self-exams, because there isn’t enough evidence that women who examine their own breasts have better outcomes than women who don’t. In fact, according to the USPTF, “there is moderate certainty that the harms [of teaching breast self-exams] outweigh the benefits.” Women who do conduct breast self-exams receive more biopsies. And the USPTF noted that breast self-exams may even cause “psychological harms” such as worry or anxiety or other harms from overdiagnosis or overtreatment. For a different perspective, the American Cancer Society suggests that monthly breast self-examination is an option for women beginning in their 20’s. However, they also state that it’s okay for women not to perform breast self-examination regularly — or even at all.
What Does The Change Mean For You? The bottom line: It’s important to know your body and be familiar with what’s normal for your breasts. And if you notice any changes, be sure to get them checked out by your doctor. Whether you’ve been doing breast self-exams and feel comfortable continuing, or you’d like to come up with some other way to track your breast health, the important thing is to talk to your doctor and come up with a plan. When you’re talking to your doctor about screening, for cancer or any other illness, you will both want to consider factors such as:
How common the disease is
What your specific risk factors may be
The accuracy of different screening methods
How likely it is that earlier diagnosis or treatment would improve your health in the short and long run
Back to breasts: If you notice a lump, a change in appearance of the skin over your breast, or liquid discharge from or change in your nipple, you should be evaluated by your healthcare professional as soon as possible. He or she can help determine what may be causing these changes and create a plan for next steps in managing your health. (By the way – men, that goes for you and your breasts, too!)
Dr. Roslyn F. Schneider is the Global Patient Affairs Lead driving patient-centricity within Pfizer's Medical Organization. Previously, she was in clinical practice and medical education for twenty years in New York City.