The VALUE of the Self Breast Exam (SBE)

elimar86861

I know the recent controversy over the U.S. Preventive Services Task Force new guidelines puts the biggest focus on recommendations for mammogram screenings, however, I also take exception that the USPSTF also

"Recommends against breast self-exams based on findings from two large studies showing the practice to have no value."

I found my 7mm tumor through self-exam.  Besides mammography as a first line of detection, of course women should be instructed to know their own bodies and be alert to any change in the breast.  So KEEP DOING THE SELF EXAM IF YOU THINK OF YOUR LIFE AS SOMETHING OF VALUE.

Comments?

cakeisgreat

I agree!  I had no lumps but did exams.  My onc (for melanoma), gyn and primary physician also always did them.

KEW

I found my lump 6 months after mammogram, 17th, I  started at 30.  My PCP couldn't feel it, I insisted on a diagnostic mammogram--huh, two lumps, totally 2.6cm, located in a hard to see place with a screening mammogram.

My mom had mammogram 6 months later she had breast pain, was told bc doesn't hurt. Finally, got another mammogram, lump, and sadly, my mom only made 3 years and died at 58.

I tell my friends to feel themselves up REGULARLY.

Hugs--Karen 

Leah_S

I found my lump 10 months after a clear mammo. Went for mammo and u/s. Mammo was STILL clear but mass shown on u/s. IDC, 1.6cm tumor, 6 nodes. If not for self-exam it would not have been found. I don't like to even THINK about what would have been the result.

Leah

crazy4carrots

I think high school girls should be taught BSE in their health classes.  Getting familiar with their breasts may help to make them less afraid in later years that they'll find something.  I found a lump at age 20 which was examined by 3 docs the SAME day!! and determined to be a cyst.  But I had been made aware by my mother who, 3 years before, had been dx'd with BC.

Having said that, my ILC at age 59 was only discovered via mammo and U/S -- no lump felt.

lvtwoqlt

Our local breast cancer facilitator is going to the local high schools and giving the BSE instructions in the health classes.

I didn't feel a lump when I was diagnosed, but prior to my dx I found several lumps that were cysts.

Sheila

janey47

I have dense breast tissue and "lumpy" breasts and I have always believed that it was *more* important for me to do bse because I'm the only one who knows the textural map of my breasts.  I've been having lumps in my breasts since I was 18 and yeah, the first one was really frightening until I realized the pattern (too much caffeine, blah blah, go away after next period).  When I found the lump early this year that turned out to be cancer, I knew immediately that it was different.  I didn't let myself worry too much because of my history, but I honestly wasn't all *that* surprised when I got the results of the biopsy.  But this lump, even after being confirmed by my doctor, wasn't picked up on the mammogram, and even after it was biopsied & confirmed to be malignant was *still* not found on the mammogram.  A second lesion was found by an MRI.  I know my experience is by no means universal, but for myself I don't have a huge amount of faith in mammograms but oh you bet I won't stop self exams and I sure as hell won't stop telling all my female friends to do theirs.

my2boys

I found my lump during a breast self exam.  My breasts were always lumpy, but because I knew my breasts, I was able to immediately distinguish between normal "lumpiness" and cancer.  I knew right away that this lump was different than the others.

Telling women that breast self exams have no value is crazy....plain and simple.

mbtlcsw01

I was having mamograms every 6 months with sonograms.  All this missed the 1cm tumor because of dense breast tissue.  If I had not done self-exams and been educated about what to look for, I would not live to see another year.  BTW  I have a son in drug/alcohol treatment.  He called me @ 7:30 am this morning to tell me his roomates saw this on the front page of the paper and woke him up to call me. 

I'm a federal government worker, but this is an example of pure STUPIDITY.  KEEP ON EXAMING YOUR BREASTS--THOSE OF YOU WHO STILL HAVE THEM.

fortunate1

Self Breast Exam is what saved me. My breasts are/were dense and lumpy, but no one ever told me that was a problem, just a fact. Mammos showed nothing but dense breast tissue. I found my un-mammogramable Lobular tumor because it conveniently formed an atypical lump. What if it hadn't? How come we're not told about thickening tissue? I tell any woman who will listen that self breast exam can save her, and that some tumors don't form a lump. 

As for mammograms, we need more and better detection, not less. 

Marie821

Found my lump last year at age 47.  It was in the lower part of my breast, next to my rib - did not show up on a mammogram.  Self exam more than likely saved my life.

pk0199

Going to jump in here even though I am from Canada. Where I am the Alberta Breast Screening Program is also not recommending self breast, yet they tell patients they need to know their breasts. I know, huh! IMHO, the reason the powers at be do not want us doing self breast, is then a lower number of  "lumps" found by patients, decreases the number of visits to physicians and therefore limits the number of diagnostic studies needed to be performed. We do tons of exams for cysts and thick parenchymal tissue that are benign therefore "wasted tax dollars". But to me, doing 100 patients for benign testing is worth it just to find and save just one.  So keep on doing those self breast exams and if you find something, go get it checked out, that is what the medical community is there for, to help save lives and you "can't" put a price on that!

AnnNYC

Since so many "experts" consider our "anecdotes" so meaningless, here's some more "data":

A paper from Seattle says 48% of breast cancers are first detected by self-exam
(see: http://www.ncbi.nlm.nih.gov/pubmed/12209738)

and a 2009 paper from Mass General/Harvard says 71% of cancers in women under 40 are first detected by self-exam!
(see: http://www.ncbi.nlm.nih.gov/pubmed/19800464)

I wrote a lot more about the "two huge studies in Russia and China" that were cited by the Task Force as evidence for the "worthlessness" of BSE - hope you don't mind my linking to that post:
http://community.breastcancer.org/forum/110/topic/744039?page=2#idx_41

elimar86861

Those studies in Russia and China are meaningless and absurd to those of us who detected our own cancers!  

cakeisgreat

And women ages 35-50 SHOULD be taking care of themselves because they are raising the next generation and offering society excellence by their careers just as much as the age 50-75 girlfriends have done in the past and continue to do so.  And what, when you turn 75 years old it doesnt matter anymore? 

UGH! 

LVLinda

pk0199 - I totally agree with you.  If women are told SBE's are not effective, they won't do them.  If they don't do them, they won't find anything wrong.  If they don't find anything wrong, they won't go to their doctor.  If they don't go to their doctor, the insurance companies won't have to pay anything.  It's all so clear to me, and it stinks!  Guess we shouldn't know our own bodies?  Guess we shouldn't take care of ourselves?  Looks like we are slipping back into the dark ages, it's just downright terrible.  I cann't believe this is happening in 2009....wow....

Linda in LV

AnnNYC

elimar wrote:

Those studies in Russia and China are meaningless and absurd to those of us who detected our own cancers! 

I know!!!  It's just appalling to me that that's what these new guidelines are supposedly based on!

momand2kids

I also find it disturbing that they suggested that even in office breast exams by a doctor were of questionable value.

My 2.5cm lump was found by my pcp in my regular physical exam.  I am not sure I could have ever found it in my dense breasts, and my mammogram 6 months before did not pick it up.... Her catch got me into treatment early--- while my cancer had not spread, it was indeed invasive and would have made its nasty way into the rest of my body.... was I over-treated?  Possibly, but it worked for me.  These people making these suggestions have no idea what this feels like...... 

gobuster

I found 2 lumps through BSE on Sept. 20th, 2009.  I had a clear mammogram 4 months prior to my self exam.   I am grateful every single day for my self exam that day!! 

Mammogram never revealed my cancer....  Utrasound revealed the 2 areas I had already found.... MRI revealed 3 areas of cancer..... Surgery revealed 4 areas of cancer.

I shudder to think where I would be if I hadn't checked on that day. 

I was consider LOW RISK for developing breast cancer prior to my diagnosis.  I am 40 years old. 

kira66715

I found my lump 6 months after a normal mammogram, my ob/gyn couldn't feel it, but ordered the mamm/US that showed the 1.6 mm invasive ductal carcinoma with ?LVI. If I'd waited for my next mammogram, it definitely would have been more advanced.

I always have had lumpy breasts, and I felt it while reaching for the bedside lamp, but immediately knew it was different.

My gyn kept saying "it couldn't be felt"--then why was I in her office, the first appointment I'd ever made for a problem.

Self exam likely saved my life. And mammogram--at age 49--made the diagnosis.

The USTF are nihilistic morons--in the past they declared there was no data to support skin exams to detect skin cancer....

Kira 

JustmeAlicia

Self exam was key for me.  My prior mammo was fine 10 months prior to me palpating a lump.  The area was biopsied 2 times prior so I knew I always had something there, well it grew.  TO 4 cms ~ it was vague even on mammo due to my dense breast tissue.  Confirmed cancer after a core needle biopsy.  MRI revealed a second lump that did not show on mammo.  I think every tool needs to be used.  Mammography can definately not be ruled out until a woman is 49, and to say SBE is a waste to even educate women is completely ludacrious.  WHO better to know our breasts then US.  This who thing is sickening.  Any life lost due to cutting back on testing is a sin.  They should be ashamed of themselves.............. 

Alicia

LVLinda

JustmeAlicia - My situation is almost exactly like yours.  My prior mammo from 10 months previously showed nothing new, but I found my cancer because of my self exams.  Mine was 3 cm when I found it.  If I had not done my SBE, no telling what would have happened.

For anyone, or any organization to dare say that Self Breast Examinations are not effective, well, I think that's criminal!  I listened to a rep from the so called "team" that came out with these findings, speak with Wolf Blitzer on CNN today and I just could not believe what was coming out of her mouth.  I wish I could remember her name.....but it was total crapola.  If she's supposed to be an "expert" who is making decisions on what can determine whether someone lives or dies, we are all in trouble.  I just could not believe what I was hearing.....it was totally disgusting.

Linda

otter

I am one of those women for whom mammography was not helpful.  I had mammograms regularly since age 40, but the density of my breasts obscured any lumps that might have been there. Nothing was ever mentioned about my dense breasts in my mammo reports or by my GYN, though.  The first I learned about it was from my breast surgeon, when we met to plan my mastectomy.

I found my lump myself.  My "mammographically dense" breasts had always been full of lumps and bumps -- fibrocystic tissue.  I had an awful time trying to sort it all out, and I asked my GYN at least 3 times to tell me how to distinguish the "normal" stuff from a "bad" lump.  He wouldn't tell me how to do that.  I guess maybe he already thought self-exams were worthless.  He did keep telling me to "look for changes."  Well, my lumpy-bumpy breasts were changing constantly.  I had lots of pain and swelling with PMS, and the lumps would come and go.

Then I discovered a lump that did not come and go.  I pointed it out to my GYN but he said he couldn't feel anything; and the screening mammogram I had a few weeks later was "normal".  I was still able to feel the lump at my next GYN visit, but my GYN told me it was just fibrocystic tissue and was the same on both sides. Once again my screening mammogram came back "normal".  I guess that means clinical breast exams are of "questionable value"?

My cancer was finally dx'd at a large breast health center where my GP referred me when I complained about my GYN's inattention to the lump. So, if I had not felt that lump and realized it was not part of the "normal" architecture, my tumor might still be in my breast.  At least now it's in a jar of formalin on a shelf in the Path Lab.

I can understand why a panel of "experts" might look at a file full of numbers and decide that self-exams are "of no value."  I know how hard it was to differentiate "normal" from "suspicious" in my own breasts.  I did have two cysts aspirated over the past 10 or 12 years; both were "benign".  Those incidents would have been counted as false-positives, since they were lumps I detected that turned out not to be cancer.  That's why the panel said self-exams were of no value -- it's because women detect things that then must be investigated and usually turn out to be benign.  If we're not examining our breasts on a regular basis, we're not detecting those lumps and not having those procedures done.

It might sound as if "discouraging" self-exams (or the teaching of self-exams) would not save any money, because doing a self-exam doesn't cost anything.  But, having a suspicious lump investigated isn't free, even if it just amounts to a doctor's visit and doesn't even lead to imaging or a biopsy.  And, according to the USPSTF guidelines, those false-positives cause women too much anxiety and stress.  Do they really have a CLUE what's going on in our minds?

Yeah, I'm really sure they're looking out for our interests through all this, aren't they...  This whole thing really is making me way too angry.

otter 

sheila888

 SHEILA

sheila888

 SHEILA

mlkelly58

At age 48, I found my 2cm lump through SBE 4 months after a negative mammogram, and the doctors and ultrasound technicians had a difficult time finding it.  If I had waited for any type of screening until age 50, I would have been Stage IV instead of Stage II. 

Beware:  This is a single, early example of what health care "reform" means.  It is government intrusion into our lives and interference in the relationship between physicians and patients.  When standard of care in medicine is determined strictly by number crunching panels, people will die.  This is frightening!  Call your senators before the bill comes to vote on the floor.  Lives are at stake.

elimar86861

That;s a good point.  The new guidlelines would have us NOT doing the SBE at all,  and waiting until age 50 to get a first look screening.  And in the meantime?  What does that leave us?   Unless your cancer formed a lump (and not all do) and was painful (and so many are not,) the cancer would just go unchecked.  I guess there is always the chance that it might be found in a clinical exam, which the guidleines have questioned the value of but at least are not telling the doctors to stop giving them.  Yet.

ravdeb

I found my lump myself. Mammogram confirmed it.

Colette37

That is how I found my cancer!

It is as if this government taskforce WANTS to kill women.  No, touching your breasts and minimizing any lumps that a woman may find if they are under 50.  And no getting mammograms until you are 50..no reason to worry about the dangers of not knowing...yada yada yada...

I am 37 and found my cancer when I was nursing my daughter.  It was IDC.  I had 6 treatments of chemo before I had surgery.  When it came out I had zero IDC left (I could not feel a lump any longer and I thought that I was one of the few who wouldn't need rads and was doing well)    I STILL had a 10 cm (you read that correct) lump which was DCIS that you could only see on Mammogram.

So, yeah, mammograms AND self exams are very important.

MsMonty

I found a 'thickened" area while doing a self exam in Dec. 2004. My regular OBGYN appointment was in Jan 2005. She said she could not feel anything but to have them mark the area when I had my mammogram. I had the mammogram in Feb 2005 and they marked the area of my concern. In March 2005 I received an all clear on the mammogram.

I wanted to file away the results and go on with my life but I just knew my breast was different. I called my OBGYN and told her I wanted more tests given a very strong family history of breast cancer. She sent me for a biopsy which occurred late March 2005. The results indicated an ILC breast cancer. The tumor was the size of an egg.

I know that I may well not be here had I not done routine SBE and also had I not stood up and said, "I want more".

I had radiation as part of my treatment and I told the radiologist about my egg sized tumor not showing up on a mammogram. He told me that looking for a tumor with a mammogram on women with dense and or large breasts is like looking for a snowman in a blizzard.

I lost my mother and her sister and two first cousins to breast cancer. I have two well endowed daughters and I want them to have an MRI rather than a mammogram.

Sharon

lottie

I found my lump during a self-exam after experiencing pain in my breast. One week later it did not appear on mammogram. A MRI confirmed it. I'm 51. I don't think mammography was especially useful in my case, but I would never ever discourage women from an annual mammogram starting at age 40 (35?), and never discourage self-exams. I do agree with Dr. Love however who says that we need to find a test that is more reliable.