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Breast examination "no use" in cancer fight - Canada
( 2001-06-27 16:31 ) (7 )

Monthly breast self-examinations, for decades recommended as a good way of helping women detect the first signs of breast cancer, are in fact of little use in fighting the disease and could even be harmful, a group of Canadian experts said on Tuesday.

The Canadian Task Force on Preventive Health Care said a careful review of seven international studies into the effectiveness of breast self-examination showed the practice had no effect on increasing the life of cancer sufferers.

The task force -- whose report was published in the Canadian Medical Journal -- said women should rely instead on proven methods for detecting breast cancer such as mammograms and breast inspections by trained medical professionals.

"There was no evidence to support the benefit from self-examinations in terms of reducing mortality from breast cancer," said task force member Dr John Feightner.

The report said examinations could be harmful, since women were likely to suffer from anxiety after finding a lump and many had biopsies on lumps which turned out to be benign.

The task force recommended that women aged 40 to 69 no longer be routinely taught to carry out breast self-examinations, in part because few did the tests regularly and ever fewer did them properly.

The experts came to their conclusion after looking at self-examination studies conducted by doctors from China, Russia, Britain, the United States, Canada, Finland and Japan.

Breast cancer is the most frequently diagnosed cancer among Canadian women and accounts for 30 percent of all new cancer cases each year. The task force said an estimated 19,200 Canadian women were diagnosed with breast cancer last year and 5,500 died from the disease.

Some breast cancer experts welcomed the task force's findings, saying it backed up what they had been saying.

"The annual physical is the time to get checked. The question is: Does it hurt to check in between? Well, it may," said Dr Pam Goodwin, director of the breast center at Toronto's Mount Sinai Hospital.

"It may lead to the detection of abnormalities that are not clinically important and it may also lead to women having a false sense of safety if she misses something that should be investigated," she told CBC television.

But by no means everyone agreed with the task force's recommendations.

The Canadian Medical Journal published a commentary by two Harvard Medical School doctors saying it was too soon to be contemplating such sweeping changes.

Larissa Nekhlyudov and Suzanne Fletcher said the results of a major Chinese study quoted by the Canadian task force should be treated with caution since it was only based on five years of follow-up.

"Had we reached conclusions on the effectiveness of screening mammography or colorectal cancer screening after five years, we would have declared that screening was detrimental because the mortality benefits were not yet clear," they wrote.