Aug. 14--Though recent studies indicate breast self-exams do little to prevent breast cancer, local health professionals still view the exams as an important tool in early detection and prevention.
A new study by the Cochrane Collaboration, an international organization that disseminates medical information, found that breast self-exams don't help reduce breast cancer deaths. In 2003, the American Cancer Society stopped recommending the exams, labeling them as optional.
Local breast oncologist Sibel Blau and oncology nurse Donna Banks, both with Good Samaritan, encourage their patients to perform the exams.
"I really still recommend self-exam to my patients," Blau said. "A careful self-exam can help early diagnosis."
If women are familiar with their breasts, they will notice a change or lump, she said.
"The more informed they are, the more comfortable and confident they are," said Banks, who also provides emotional support and education to patients.
Many women accidentally find a breast lump in the shower, but sometimes it could have been caught sooner if self-exams were performed, Banks said. Still, the women wouldn't have noticed if they weren't feeling for it in some way or another.
"If you know your breasts -- you know how they feel -- you will be able to detect something yourself," Banks said. "Because of that it's found sooner."
When conducting a self-exam, there are a few different changes to look out for, including any discrete, hard lumps in the breast tissue; discoloration of the breast; skin thickening or dimpling; nipple retraction; palpable lymph nodes in the armpits; and discharge.
There are some limitations to the breast self-exam, Blau said. Women who are still menstruating should make sure to perform a self-exam after their period because their breasts will be less tender and swollen. Women on estrogen-replacement therapy will experience engorged breasts, which makes it harder to detect changes.
If a lump is found and confirmed to be suspicious by a physician, a mammogram should be performed, though an ultrasound or MRI may also be necessary to determine if it's cancerous, Blau said.
Some women avoid self-exams because they're afraid of what they find, she said. But finding and dealing with a lump early on can be a life-saver.
"The earlier they can find it, the better," Blau said. "I think it's a matter of education."
It takes years for cancer cells to develop into invasive cancer and at least two or three years before the cells would be seen in a mammogram or felt through a self-exam, Blau said. Even before the lump is palpable, it can be cancer.
It also depends on the biology of the specific cancer, Banks said. Some are slow-growing over a number of years, and sometimes tumors can develop within months.
In addition to the self-examination, yearly clinical breast exams and mammograms for women 40 and older are recommended. It's really the pairing of these methods that help catch cancer early.
"Self-exam is not enough," Blau said.
Breast cancer can be found in women from their mid- to late-20s through their 80s, but the ages 40 to 70 are the most common, she said. Younger women with the cancer tend to have a family history of the disease.
In general, prevention starts at maintaining a healthy lifestyle and being aware of the way your breasts feel so that changes do not go unnoticed, she said.
"I think it's an educational tool," Banks said. "I think it's totally necessary. Be healthy, have your mammogram and do your exams every month."
Reach Reporter Roxanne Cooke at 253-841-2481 ext. 314 or by e-mail at roxanne.cooke@puyallupherald.com.
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