On Breasts

Now that I've got your attention, let me say first of all that what follows is written by a man -- a man who is not a scientist, not a doctor, and not a woman. I do not face the threat of breast cancer with the same level of immediacy that a woman does. I do not have to diagnose it, and I don't do research on it.

Nevertheless, I have to ask: Why in the world would you stop doing a self-exam that is quick, free, and saves lives?

I read Linda Ellerbee's opinion piece in this morning's C-J, and I think she points out what we all know: studies don't trump common sense. Statistically, some studies show that breast self-exam (BSE) does not help: it does not lower the mortality rate, and it does not lead to earlier detection. These same studies also seem to show that women who practice BSE suffer through more biopsies, most of which are benign.

My first reaction is that the studies must be flawed. How can self-examination not result in earlier detection? Since I haven't read the studies in depth, I can't argue with the findings, even though they seem strongly counter-intuitive to me.

What I CAN argue with is the recommendation drawn from the study: stop doing BSE, because it doesn't make a difference. Let me tell you -- it made a difference to Linda Ellerbee. In fact, it saved her life.

The recommendations also lowered the schedule for mammograms. So what are women supposed to do now? Stop getting mammograms, stop doing BSE -- sounds to me like the medical establishment is saying "It doesn't matter what you do; if you're going to get breast cancer, you're going to get it, so don't worry, be happy. Que cera, cera."

I'm just a male blogger, posting my opinion in a little corner of the intertubes, but it seems pretty obvious to me: breast cancer kills, early detection is good, and BSE is easy and free. If I was a woman, I'd be doing it every month, study or no study. As Linda Ellerbee says, I'd rather be a live anecdote than a dead follower of the latest recommendations.

Comments

[Rob Yoder]

I'm going to have to agree with you on this Bruce. We have spent a large amount of resources in the past century convincing people to take control of their health, teaching them how to self-monitor and to recognize symptoms. As a result, average lifespans are way beyond what anyone could have imagined a century ago.

Here's my key point on this issue - Let's just assume that the study is correct and that self-examination not a good indicator of success. So, we need to ask the follow-up question - is there any benefit?

I would argue a hearty "Absolutely!!" The biggest benefit to women's health not been the individual results of self-examination. It's been implementing the idea that we each are responsible for our health. It's building the habits and routines that actually DO produce tangible benefits. A regular self-exam puts health on the radar every month.

It's a direct contradition to a huge problem we face in men's health. Too few men practice regular self-exams. Too few men even bother with annual check-ups! How many of us have fathers who hate to talk about health, are embarassed by the topic and have to be pushed (sometimes almost literally) to get their colonoscopy screening.

Just because the direct benefits of a FREE procedure don't provide a grand payoff, doesn't mean that there aren't secondary benefits that make it worth the while.