Be aware: How often should you be performing breast self-exams?
For decades, the recommendation for women was to perform breast self-exams once a month beginning at age 18. But according to the American College of Obstetricians and Gynecologists (ACOG), this practice is no longer necessarily recommended in average-risk women.
While it is still recommended that women 40 and over receive regular mammograms, evidence has shown that monthly self-exams are not a reliable measure for cancer detection. In fact, women who performed BSE had higher numbers of false positive results, leading to nearly twice as many unnecessary biopsies. “We were performing biopsies and invasive surgeries on women with benign disease more often,” says Ross Hanchett, M.D., an obstetrics and gynecology physician at Adventist Health Feather River.
According to ACOG, “Regular screening mammography starting at age 40 reduces breast cancer mortality in average-risk women…however, it also exposes women to potential harms, such as callbacks, anxiety, false-positive results, overdiagnosis and overtreatment.”
So what’s the appropriate action?
Self-awareness and education.
Dr. Hanchett says that if women already have habits of self-examinations, he doesn’t try to change them. “And in high-risk women I will also encourage them to continue monthly exams,” he says. “The general principle of breast awareness is to know what you look like, feel like and if anything changes, see your doctor.”
If you are a high-risk candidate for breast cancer with a family history of the disease, Dr. Hanchett recommends getting mammograms ten years prior to the youngest person diagnosed in your family or at age 40, whichever comes first.
In line with Dr. Hanchett’s recommendations, ACOG revised their guidelines in the summer of 2017 to focus primarily on shared decision-making between patients and their healthcare providers. Just as Adventist Health focuses on more than just the body’s healing, ACOG’s new recommendation “considers each individual patient and her values,” which includes decisions about when to start screening, the frequency of screening and when to end screening. You and your healthcare provider should be a champion for your health.
And a lot can be said for genetics. “I feel that the biggest intervention we can make in a woman’s lifetime risk of breast cancer is assessing need for genetic screening.” Says Dr. Hanchett. “Finding a high-risk genetic lesion like BRCA I or II and having a prophylactic mastectomy/oophorectomy can be lifesaving.” If you want to know more about genetic screening, talk to your healthcare provider.
Just like women, men can also be diagnosed with breast cancer. While less than 1 percent of breast cancer diagnoses occur in men, it is still a concern—especially since men can be less aware of changes in breast tissue and delay going to the doctor. That’s why it is so important for women and men to discuss their personal risks of breast cancer with their healthcare providers regularly—and to always be self-aware.