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Evidence summaries

Self Examination for Breast Cancer

Breast self examination as a screening method appears not to be effective in reducing breast cancer mortality. Level of evidence: "B"

The quality of evidence is downgraded by study quality.

Summary

A Cochrane review [Abstract] 1 included 2 large population-based studies from Russia and Shanghai with a total of 388 535 women comparing breast self-examination (BSE) with no intervention.There was no statistically significant difference in breast cancer mortality (RR 1.05, 95% CI 0.90 to 1.24; 587 deaths in total). In Russia, more cancers were found in the breast self-examination group than in the control group (RR 1.24, 95% CI 1.09 to 1.41), while this was not the case in Shanghai (RR 0.97, 95% CI 0.88 to 1.06). Almost twice as many biopsies (3 406) with benign results were performed in the screening group compared to the control group (1 856), RR 1.88, 95% CI 1.77 to 1.99.

A detailed discussion on breast cancer screening and BSE is available in IARC handbook of cancer prevention published by WHO 2. There is inadequate evidence that teachingbreast self-examination reduces breast cancermortality or the rate ofinterval cancers. There is also inadequate evidence that breastself-examination reduces breast cancer mortalityin women who practise it competently andregularly.

Note: BSE must be distinguished from breastawareness. BSE is a screening method used toattempt to detect asymptomatic breast cancerbefore it is clinically apparent. Breast awareness consists ofthe education and encouragement of women toseek medical attention for symptomatic changesin their breasts that may be due to the presenceof breast cancer.

Primary/Secondary Keywords