Breast Self-Examination: the Case for a Second Look

Abstract

Purpose of Review

Breast Self-Examination (BSE) remains controversial despite the 2009 United States Preventive Service Task Force (USPSTF) recommendation against teaching of BSE. The USPSTF recommendations were based on results from the Shanghai Study, a high-quality randomized trial of BSE in 266,064 Chinese factory workers from 1989 to 1991; women instructed in BSE did not have a significant difference in mortality versus uninstructed controls. Regardless of the outcome of the Shanghai Study, the practice of BSE in the US over the past 25 years has been associated with a marked reduction in the size of breast cancer identified by women.

Recent Findings

In the Shanghai study, BSE was tested in China from 1989 to 1991. During this time period, Chinese breast cancer screening and treatment was not consistent with standard-of-care in the US and Europe. Breast cancer was a rare illness in China in the 1980’s. Treatment was not standardized; there was no breast imaging or margin assessment of the tumor. Tumor markers (e.g., estrogen receptor, progesterone receptor) were not reported. The Shanghai Study did not report in detail on the anti-cancer agents provided to women who enrolled in the trial.

Summary BSE Needs to Be Rigorously Re-Evaluated under Current Standard of Care

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Fig. 1

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Correspondence to Victoria Seewaldt.

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Eric Dietze reports grants from NIH/NCI to City of Hope during the conduct of the study. Veronica Jones and Victoria Seewaldt declare no conflicts of interest relevant to this manuscript.

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Dietze, E., Jones, V. & Seewaldt, V. Breast Self-Examination: the Case for a Second Look. Curr Breast Cancer Rep 12, 118–124 (2020). https://doi.org/10.1007/s12609-020-00358-z

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Keywords

  • Breast self-examination
  • Breast cancer screening
  • Early detection