Breast Self-Exams: Don't Let the News Confuse You

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My wife has fibrocystic/dense breasts.
Every year she has a routine mammo which always mentions this
condition in the reports.I recently found a lump in my wifes right breast at the common 9oclock position. The next day she had an ultrasound which confirmed the mass. then a core biopsy which came back as cancer.Stage IIB one right axilla node as well
She also had another mammo right after the biopsy and ultrasound
which again did not reveal the mass. All these years never did any of her Doctors or Radiologists ever suggest or send her for
an ultrasound which is supposed to be the backup exam for dense
breast tissue.When asked why I was told her breasts though dense were not dense enough to warrent the ultrasound. Ultrasounds are only done if something is spotted on the mammo.Since then I have
found many other women who have somehow slipped through this same
crack.Shouldnt ultrasounds be routine with mammos in these cases?

Chris Martino of NJ 1:31PM March 04, 2009

I found my own breast cancer, too. Thank goodness I had a lump or I would have been sent home with a pat on my head. I went to my PCP and said, "I think I have IBC!" and he said no, it wasn't, and sent me home. I went back to another dr. with the same complaint two weeks later. This dr. said it wasn't cancer, either, but it was time for a mammo. When I went to get the mammo I said the same thing and they said no-it's mastites. Then they found the lump, but thought I was stage 1. I was really stage 3 (IBC). Now I'm stage 4 but thankfully, still alive.
Don't depend on a doctor to save your life!

Kim T of TX 3:45PM July 22, 2008

My concern with this new research is that it will take us backward in terms of improving awareness and removing the stigma of being diagnosed with breast cancer. There are huge populations of women (predominantly lower-income) who may not receive regular medical care and ignore changes in their breasts until it is too late. After years of grassroots efforts (including the distribution of shower cards and pamphlets promoting monthly self-breast exams) by rural health professionals and non-profits, that stigma is finally being eroded.
These "findings" and the manner in which they have been reported are a disappointing set-back to those of us who have worked in these communities to help detect and treat breast cancer before it's too late. Yes, the average woman SHOULD be able to determine, on her own, any changes in her breast tissue. But it is absurd to assume that, without monthly exams, everyone would recognize changes on their own and in enough time for treatment. In the absence of these exams, you would be amazed at the explanations some women -- particularly those living in rural communities -- have for lumps.
I'd like to know how many of the women in this study were lower-income? How many were African-American? How many had less than a 10th grade education? Because I can say with some certainty that these are the groups that benefit most from monthly self-exams.
A follow-up story is warranted, in my view, that presents this side of the story.

HW of SC 11:38PM July 19, 2008

I am only 28 years old and I found out first hand how important this is. Last year I found a lump in my right breast and it was removed a week later by full biopsy. Luckily it was not cancerous however I do have Fibrocystic disease. I'm greatful it was removed before it could have progressed into something else.So moral of the story here. You're NEVER too young to get your breast examined.

Brandi of TX 11:27PM July 18, 2008

It's Katherine Hobson here: if you read the article, you'll note that no doctor at all is advising you don't touch your breasts or report changes to your doc. To the contrary, being familiar with your breasts AND reporting any changes is essential. What these studies looked at was whether a formalized training program that advised women to regularly check their breasts once a month made any difference in the number of women who died from breast cancer, and it did not, for the reasons spelled out in the piece. Also, the evidence on this has been strong enough so that the American Cancer Society now has a formal BSE program as optional, and the Susan G. Komen for the Cure also does not specifically recommend BSEs.
KH

Katherine Hobson of NY 2:59PM July 17, 2008

I had fibrocystic (read lumpy) breasts. My mammogram was clean the previous October. My July BSE had all the usual lumps. Three weeks later I had an achy itch on the outside of my right breast. Thanks to good medical coverage, only two and a half weeks later after mammography, ultrasounds, MRI & biopsies I had a mastectomy. It was an aggresive stage 2b lobular carcinoma. I am now a survivor.
I urge every woman that I can to do BSE. Eighty percent of breast cancers are found by women themselves. It is our responsibility to know our bodies, lumpy though they may be.
To treat BSE with such cavalier indifference, especially for those of us with fibrocystic breasts, can and will result in tragedy.

Pearl Olson-Boots of WA 2:56PM July 17, 2008

I completely disagree and will continue to perform this examination on my wife. In the interest of health, I will try to perform the exam at least three times a week if she lets me. Sorry, I couldn’t help it. Seriously, no matter how much they do or do not help, being familiar with your body and examining it regularly definitely won’t hurt.

of GA 2:00PM July 17, 2008

I'm very upset about this article. I'm the one that discovered a change in my breast.
My mammogram didn't show anything other than dense breast tissue. Because I discovered a lump that grew slightly, the hospital did an ultrasound, and I had to show them exactly where the lump was so they could discover it. It was cancer. This is the one test that doesn't cost woman anything. I'm horrified by this article.

nancy gold of CO 1:55PM July 17, 2008

Lois and CJ, you both are missing the larger point of this research--the was no real difference in the mortality rate of monthly self-examiners vs. non-examiners.
"Following an exact, lengthy protocol on the same day of every month is no better and isn't necessary... If you feel something unusual, however you find it, get it checked out."
CJ, that unusual discharged saved your life and Lois, and others who noticed changes or lumps and had them checked out are now survivors. And that's how it should be. Each individual must take control of their own health and see their doctor if they have concerns.
These researchers aren't saying forget about self-exams, but if you aren't regular about it don't freak out if you miss a couple of months. It's the same concept with moles/freckles. Melanoma is a lethal and fast developing cancer that kills thousands, yet you don't hear of any rigorous monthly protocol to examine every mole.
No one knows your body like you do. We just need to be aware of changes as we age and ask good questions when we seek answers.

A Beason of TN 12:17PM July 17, 2008

I strongly disagree with the message of this article. In June 2001 I had a mammogram which was pronounced as "clean." In October, when I went to see my family doctor for bronchitis, I mentioned that I had noticed a nipple discharge from my right breast. The PA took a smear sample and had it examined. Within two months, I underwent surgery. The mastectomy removed my right breast which was filled with ductal carcinoma--whoever examined my mammogram missed it.
Since I had no lumps, I hadn't been overly concerned--after all, I'd just had a mammogram, so I couldn't have breast cancer, right?
My self-exam and my question while in my doctor's office saved me, not the moron who misread my mammogram result.

C. J. Owens of IN 6:31AM July 17, 2008