Does Breast Self-Exam Help Detect Cancer?

In 2022, breast cancer claimed 670,000 lives worldwide and became the most common type of cancer in women in 157 countries. What’s even scarier is that about half of all breast cancer cases develop in women who have no risk factors other than age (over 40). In other words, a healthy lifestyle will not necessarily protect against this disease.

The sooner a woman notices cancer and begins treatment, the greater the likelihood that the disease will be brought into stable remission – stopping the growth of the tumor and preventing its recurrence in the next five years.

Self-examination of the breast is considered one of the ways to detect a tumor . However, in the scientific world there are considerable doubts about the effectiveness of this method.

Does Breast Self-Exam Help Detect Cancer?

A 2003 Cochrane review of 388,500 people found that self-examination does not help reduce breast cancer mortality. In addition, among women who perform home examinations, many more patients undergo biopsy of benign tumors. That is, they find “lumps” in their breasts, worry, spend time and money on examinations, after which it turns out that it is not cancer and there is no threat.

The review authors concluded that there was insufficient evidence for the benefits of breast self-examination.

In a review of eight studies, the researchers also concluded that self-examinations do not help diagnose cancer or diagnose it at an earlier stage, and do not affect breast cancer mortality.

However, despite these data, breast self-examination cannot be called a useless method. At least in our country. A Russian population study included in the Cochrane review showed that women who examine their breasts are more likely to find cancer than those who do not. At the same time, the 9-year survival rate in the self-examination group is 65%, and among those who do not do home examinations, it is 55%.

We know that self-examination does not affect breast cancer mortality. But I think this practice makes sense in Russia.

Of course, you shouldn’t compare self-examination of your breasts with normal screening, which includes a doctor’s examination of your breasts and, after age 40, a mammogram. But how many women in Russia do this?

Unlike Norway or Sweden, where the screening program is well organized and even family doctors examine the mammary glands, not all our gynecologists look at breasts and say: “Oh, you don’t need to see me for that, you need to see a mammologist.”

Therefore, I would leave this recommendation for our country. Patients in Russia continue to find tumors on their own, and only this makes them come to the doctor for an examination of their mammary glands.

In addition, if a woman conducts a self-examination, she remembers the “red flags”. Because some patients do not consider the change in the shape of the gland and skin color or the appearance of a lump to be a problem and do not go to the doctor with such signs. And all this can indicate a malignant neoplasm.

Even if the test results show that the changes are benign — and in most cases this is the case — I don’t see a big problem with that. What I definitely wouldn’t recommend doing without indications for everyone is an ultrasound. Because it definitely leads to additional anxiety, unnecessary biopsies and surgeries.

How to properly examine your breasts

If you decide to perform breast self-examination, it’s important to do it right. One study found that women who performed particularly thorough self-examinations were 35 percent less likely to develop late-stage breast cancer than those who didn’t do it at all.

Self-examination of the breasts is done once a month on the 5th-12th day after the end of menstruation . If you do not have a period, set any date and conduct an examination on this day every month.

Follow a few steps.

1. Stand in front of a mirror, lower your arms to the sides and examine your breasts. Pay attention to any changes in the size or shape of the mammary gland. Look for dimples, redness, sores or other changes on the skin of the breast, nipples or areola.
2. Raise your arms up and examine your chest first from the front, then from the sides. Look for the same changes.
3. Using three fingers, feel your entire breast and armpits. Start with the upper outer quadrant—the tissue is usually denser here—and move clockwise. Look for “balls,” hard lumps, or any other masses.
4. Squeeze each nipple separately between your thumb and forefinger and see if any fluid is released.
5. Lie on your back so that the tissues are distributed along the chest wall. Put your right hand behind your head. With three fingers of your left hand, feel your right breast and armpit, noting if there are any “balls” or lumps. As with the standing examination, start with the upper outer quadrant and move in a circle. Repeat the same with the left breast – feel it with your right hand, and put your left hand behind your head.

Remember how exactly you performed the self-examination – which part of the breast you started with, which direction you moved, how hard you pressed. Repeat the examination in the same way each time – this way you will be able to compare with the sensations you had last time and detect changes.

If you notice any warning signs, try to calm down. Make an appointment with your doctor for an examination to find out what is causing the changes in your breasts.

Up to 90% of breast lesions are not malignant. These may be benign lesions such as fibroadenomas and cysts, non-lactational mastitis, and other, rarer conditions.

But it is important that a woman who has discovered any of the above symptoms seeks advice from an oncologist as soon as possible. Even if she does not experience any pain. Seeking medical advice at the first signs contributes to more successful treatment.