Self-examination 'useless', breast cancer study finds

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Hope that regular self-examination of the breasts might protect women against dying from breast cancer was finally extinguished yesterday by a huge study that demonstrated it was useless.

Hope that regular self-examination of the breasts might protect women against dying from breast cancer was finally extinguished yesterday by a huge study that demonstrated it was useless.

Results from the 11-year survey of 266,000 women in Shanghai showed that the death rate from breast cancer was the same in the group taught to check their breasts as in the group given no information.

But the findings, published in the US Journal of the National Cancer Institute, caused no surprise among British experts where scepticism about the value of breast self-examination has been expressed for well over a decade.

The Department of Health abandoned the policy of advising women to examine their breasts in 1991 and the current advice to women is to be "breast aware".

This message was reinforced yesterday by the breast cancer charities. Michelle Barclay, policy manager at Breakthrough Breast Cancer, said that although the study was new "it is not saying anything new". She added: "Breast self-examination is a specific term for a taught routine examination. Being breast aware means a woman knowing what is normal or abnormal for her."

Lesley Walker, director of cancer information at Cancer Research UK, said being "breast aware" meant looking out for changes such as a new lump or thickening in one breast or armpit, any puckering, dimpling or redness of skin, changes in the position or condition of the nipple and any new pain or discomfort felt on one side.

The problem with breast self-examination is that it is expensive to teach, hard to learn and difficult to do properly. It involves a methodical search of each breast, following a set procedure and is supposed to be carried out at the same time each month.

In the Shanghai study, the researchers from the Fred Hutchinson Cancer Research Centre in Seattle found that the women who were taught the technique of examining their breasts regularly failed to spot cancerous lumps earlier than those who did not. However, they were more likely to spot non-cancerous lumps.

Dr David Thomas, who led the research, said: "We would say for women over the age of 50 mammography is a useful tool to try to detect breast cancer early and to reduce a woman's chance of dying from breast cancer whereas for general public health policy it does not appear that breast self-exams are very helpful."

The finding is the latest from a series of studies over the years that have failed to show benefit from the self-examination technique.

The US researchers say the best defence against breast cancer is screening in the developed world but the real lesson of their findings was for the developing world, where substantial sums have been invested in teaching women to examine their own breasts. "In developing countries, where mammographic screening is not available, it would not seem to be a good use of limited funds available for preventive services to promote practice of breast self-examination," they said.

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