Breast Self-Exams: Women Have “Saved Their Own Lives”
Originally published on 5 Oct. 2015 in The Hartford Courant by Deborah Percival.
When it comes to detecting breast cancer, no test is 100 percent reliable.
Mammograms miss approximately 16 percent of breast cancers, according to the Susan G. Komen Foundation. Independent studies on the efficacy of thermography report that it misses roughly 10 percent to 50 percent of breast cancers.
Yet, many leading health care authorities now suggest that women should stop doing breast self-exams, because they lead to unnecessary biopsies. The shift arose in 2009 after meta-studies in Russia and China suggested that self exams do not save lives.
“Try telling that that to a woman who found her own cancer!” said Dr. Kristen Zarfos, director of the Comprehensive Breast Health Center at the Hartford Healthcare Cancer Institute at The Hospital of Central Connecticut, who has been taking care of breast cancer patients in Connecticut for 28 years.
“Connecticut is not China. Chinese women have a much lower incidence of breast cancer than women in the United States. And Connecticut has one of the highest incidences of breast cancer in the U.S.”
Zarfos said the recommendation that women not do monthly breast self-exams “is illogical and does women a disservice. I have numerous patients who found their own cancers when other methods failed. They saved their own lives.
“Doctors commonly encourage women to check their moles, their bowel pattern, to recognize the signs of heart disease in women, and so on,” Zarfos added. “Why wouldn’t we encourage women to be familiar with their normal breast appearance and texture in order to be able to detect a change?”
According to breastcancer.org, approximately 20 percent of breast cancers are found during self-exams, including some found by women who did a self-exam even though they had received a clean bill of health after a mammogram and/or thermogram.
Breast self-exams were once heavily promoted as a way of finding cancer at an earlier, more treatable stage, but large studies, including those in China and Russia found that did not lower breast cancer death rates.
In 2009, the U.S. Preventive Services Task Force advised doctors not to teach women to examine their own breasts. The World Health Organization and the Canadian Task Force on Preventive Health Care, as well as the National Breast Cancer Coalition are among the organizations that do not recommend breast self-exams.
The American Cancer Society still recommends breast self-exams, though it has de-emphasized them, while it strongly encourages “breast awareness.” It is a matter of nuance.
Some women who have discovered cancerous lumps on their own weren’t looking for them in a deliberate self-check. But these same women now urge others to examine their own breasts regularly.
Kate Jollie of Farmington was diagnosed with breast cancer when she was 51.
“I rolled over in bed and found a lump on my side, near the top of my rib cage,” Jollie said. “I was in the best health of my life and had no family history of cancer. I thought I’d hurt myself at the gym. The possibility that it was breast cancer never entered my mind.”
She said she can’t understand the logic behind recommending that women not do self-exams.
“We are responsible for our own lives,” Jollie said.
Sharon Leonard of Farmington was reading in bed when she scratched herself and found a lump.
“I had just had a physical,” said Leonard, 64. “My doctor said everything was A-OK.”
She was about to go on a family trip but made time to go back to her doctor the next day. He checked and again said there was nothing there.
“I asked him to examine me in the position I was in when I found the lump, rather than just the standard arm-behind-the-head position,” Leonard said. “When I changed my position he was able to feel it. He still thought it was nothing, but he sent me for a mammogram and ultrasound. Both found nothing.”
Leonard said she too wanted to believe it was nothing, but she persisted and was sent for a biopsy. It was positive. She since has had a lumpectomy and is now undergoing radiation therapy.
Zarfos said that over the years she has learned that many of her patients who have detected breast cancer on their own had had a normal mammogram within the past year.
“The most effective test for finding cancer varies from woman to woman, and there is absolutely no reason to rule out an effective, non-invasive, free method that takes less than 10 minutes a month,” Zarfos said.
“Those of us who care for women implore everyone over 20, male and female, to learn how to do BSEs and do them monthly — including looking in the mirror to notice visible changes,” she said. “If you feel or see something different in your breasts, even if you have had a normal mammogram, seek medical evaluation.”