Save your breasts -- do the stroke: New recommendations for BSE

by Melissa Jaramillo

Breast ExamA monthly breast self-exam had been part of the overall breast cancer screening plan for all women. A suspicious area led to many breast cancer diagnoses and successful treatments.

It's felt that these exams, together with regular screenings by your healthcare provider in conjunction with an annual mammogram (starting at age 40) help make sure that any breast cancer is diagnosed early -- which is when it's most treatable.

Screening tests aren't perfect. Both self-exam and mammograms can result a false positive. They might find an area that looks like cancer, but isn't.

A false positive usually means more tests and follow-up doctor visits. You might have a breast biopsy. The experience can be very stressful and upsetting.

Some doctors started questioning the usefulness of BSE after research showed that regular BSE doesn't reduce the number of women who die from breast cancer, but it does result in false positives and further, unnecessary testing. Among that research was a Danish study that looked at data from two large trials.

New BSE recommendations

These concerns, and worries about promoting a more effective screening method caused the American Cancer Society to change its BSE guidelines several years ago.

They no longer recommended breast self exams, but do say that if you are comfortable they can be used as an optional screening technique.

If a friend or family member was diagnosed and treated for breast cancer because she found something during a BSE, you may think it's quite important. Any woman can to monitor her breast health with BSE, but one particular group benefits.

For young women at high risk of developing breast cancer, BSE may save a breast, providing the first hint of a problem.

The researchers looked at how the women were diagnosed with breast cancer:

• 71 percent were diagnosed because of BSE
• 24 percent were diagnosed because of a mammogram
• 3 percent were diagnosed because of a clinical breast exam

Because these women weren't getting regular mammograms yet, self examination was the most likely way for breast cancer to be diagnosed.

Women at high risk include those who:

✓ Have a known BRCA1 or BRCA2 gene mutation
✓ Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, but have not had genetic testing themselves
✓ Have a lifetime risk of breast cancer of 20 percent to 25 percent or greater, according to risk assessment tools that are based mainly on family history such as the Claus model
✓ Had radiation therapy to the chest when they were between the ages of 10 and 30 years
✓ Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes

As you choose and implement your personal breast health monitoring and cancer screening plan, consider whether you'd like to include BSE. Research or ask your doctor about the pros and cons of BSE.

Photo courtesy of iStockphoto.