New evidence debunks benefits of breast self-examination

Many studies have examined the effectiveness of various screening tools for breast cancer, which accounts for 30% of diagnosed cancer in Canadian women. In 1994 the Canadian Task Force on the Periodic Health Examination (now the Canadian Task Force on Preventive Health Care) concluded there was insufficient evidence to recommend for or against screening using breast self-examination (BSE). After reviewing relevant articles published since then, the task force states there is fair evidence to recommend that BSE not be taught routinely to women aged 40-69 years because it provides no benefit. This finding, coupled with good evidence that it led to net harm by increasing the rate of biopsy for benign breast lesions, led the task force to conclude that BSE should not be taught to women in the 40-69 year age group.

In a related commentary, Drs. Larissa Nekhlyudov and Suzanne Fletcher question whether this change is premature and wonder how women will react to a reversal in medical advice about a method that has become so widely accepted.

Preventive health care, 2001 update: Should women be routinely taught breast self-examination to screen for breast cancer?
� The Canadian Task Force on Preventive Health Care

Is it time to stop teaching breast self- examination?
� L. Nekhlyudov, S.W. Fletcher

Contacts: Jayne Graham, Canadian Taks Force
on Preventive Health Care; (pager) 519-690-4103
email: jayne.graham@sjhc.london.on.ca

John Lacey, Harvard Medical School Department of Public Affairs, Boston; tel. 617-432-0442