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Breast Self-Exam Q & A

Recent research has presented contradictory information on the importance of breast self-exams (BSE). To observe Breast Cancer Awareness month, we asked Delaware Valley doctors to answer frequently asked questions about breast self-exams.

Q:   Is the breast self-exam worthwhile?

A:   Every month there are patients who discover breast cancer through physical examination, says Kathryn Evers, MD, director of mammography at Fox Chase Cancer Center in Philadelphia.

“We also see a lot of women who feel lumps that are either benign (not cancer) or are just normal, lumpy breast tissue,” says Dr. Evers. “Overall, I think that the downside from doing (breast self-exam) is minimal and that women should seriously consider it.”

 

Additional Advice

Speak with your health care provider about BSE and consider consulting reputable websites, such as the American Cancer Society (cancer.org) or breastcancer.org to learn about BSE. Them make an educated decision that is right for you, says Dr. Kathryn Evers.

Follow up with your physician. Women in their 20s and 30s should probably have a breast exam by their physician yearly or every other year, and then discuss whether to do a monthly BSE, advises Dr. Paul Friedman.

Be aware of what is normal for you. Your primary care giver can help you establish the feel of what is normal and what you should expect to find in the course of everyday normal self-care, says Dr. Dickson-Whitmer.

American Cancer Society’s View of Breast Self-Exam

“It is okay for women to choose not to do BSE or not to do it on a regular schedule. However, by doing the exam regularly, you get to know how your breasts normally look and feel and you can more readily detect any signs or symptoms if a change occurs, such as development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk.

“Should you notice any changes you should see your health care provider as soon as possible for evaluation. Remember that most of the time, however, these breast changes are not cancer.”

► See the American Cancer Society's recommentations for early breast cancer detection.

Q:  Does BSE result in excessive testing?
 

A:  “Routine BSE does result in more biopsies, without finding more cancers,” says Diana Dickson-Witmer, MD, associate medical director of the Christiana Care Breast Center at the Helen F. Graham Cancer Center, Newark, DE. Nevertheless, area doctors agree that the chance to prevent breast cancer is worth the risk of a false-positive test.

If the reported lump is visible enough to be seen in a mammogram or ultrasound, a core biopsy is conducted. This procedure involves a minimal incision, removing solely the mass in question, which is then tested for cancerous cells. In other circumstances the entire problem area is extracted to ensure that the mass is gone, says Dr. Dickson-Witmer.

 

Q: Can there be emotional or physical harm from a BSE false alarm?

A: After having a benign biopsy for something felt on BSE, the stress from seeing a surgeon, scheduling a biopsy and waiting for results can cause women to avoid BSE or tests if they discover additional abnormalities, says Dr. Witmer.

As for physical harm from extra mammograms, “By flying from New York to California in a commercial airliner, you are getting about the same radiation as a mammogram,” says Paul D. Friedman, DO, medical director, of the Rippel Breast Center in Morristown, NJ. “These minor risks of radiation exposure, like flying in a plane, go essentially unnoticed and do not draw concern. Also, many biopsies are performed with ultrasound, which involves no radiation.”

Sarah Scarpa is a MetroKids intern and Temple University journalism student.

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