Breast self-examination does not cut breast cancer mortality

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NEW YORK (Reuters Health), Jul 16 - An analysis of data from two large population-based studies suggests that regular breast self-examination does not reduce breast cancer mortality and may actually have a harmful effect by increasing the number of biopsies performed for benign disease.

"Considering the currently available evidence, promotion of breast self-examination as a single screening method cannot be recommended," conclude Drs. Jan Peters Kosters and Peter C. Gotzsche, from the Nordic Cochrane Centre in Copenhagen. "This is particularly true because there is good evidence of harm and there are also considerable costs related to general screening."

As reported in the latest issue of The Cochrane Library, the researchers analyzed data from clinical trials conducted in Russia and Shanghai that included 388,535 women.

Breast cancer mortality was comparable for women randomized to perform or not perform breast self-examination, the investigators found.

"In Russia, more cancers were found in the breast self-examination group than in the control group (relative risk = 1.24) while this was not the case in Shanghai (relative risk = 0.97)," they report.

Overall, 3,406 biopsies were performed in the self-examination groups compared with 1,856 in the controls, resulting in a relative risk of 1.88.

The authors note that an additional population-based trial examined the benefits of clinical breast examination combined with self-examination, but because of poor compliance, the intervention was stopped and no conclusions could be reached.

While the findings suggest no mortality benefit for regular self-examination, the authors emphasize that women should still be aware of any breast changes that occur and bring them to the attention of their physician.

Cochrane Database Syst Rev 2008;3.

Last Updated: 2008-07-16 9:29:01 -0400 (Reuters Health)

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