In the furor over last week’s recommendation by the U.S. Preventive Services Task Force that women not begin having regular mammograms until they are 50, and then have them every two years from age 50 to 74 rather than annually (with exceptions for women at high-risk for the disease), another of the task force's findings has gotten lost in the scuffle. In addition to finding that the benefits of earlier mammograms, and of more frequent mammograms, are unwarranted because of "at least moderate certainty that the net benefit is small," the panel was even more critical of teaching women breast self-exam. (Click here to follow Sharon Begley).
It was also more certain.
On the mammogram recommendations, the panel recommended that doctors "offer or provide this service only if other considerations support it." On breast self-exams, it was even more negative, recommending that physicians actively "discourage [my emphasis] the use of this service." Question: for the conspiracy mongers who say that the task force's mammogram conclusions are a nefarious plot by the Obama administration (which did not even appoint the panel; the Bush administration did) to cut health-care costs by rationing a life-saving test, what are we to make of the breast self-exam (BSE) recommendation? Last time I checked, a woman who decides not to do one every month isn't saving her insurer, the government, or anyone else a dime. Yet the panel still nixed the idea that BSE should be done regularly. (It opted instead for "breast awareness": definitely pay attention if you experience nipple discharge, find a large lump, or notice any other significant change.)
Unbeknownst to most women, this isn't some off-the-wall view, as I blogged last year. The Mayo Clinic notes that "breast exams, once thought essential for early breast cancer detection, are now considered optional … [T]here's no evidence that breast exams can" save lives. The National Breast Cancer Coalition (one of my favorite advocacy groups because it hews so closely to the science, (letting the politically correct chips fall where they may) calls the idea that breast self-exams save lives "Myth #1." It's worth quoting the group's explanation:
"The evidence actually shows that breast self-exam (BSE) does not save lives or detect breast cancer at an earlier stage. For decades, women age 20 and older have studied shower cards, read pamphlets, watched videos and prodded silicon breast models to find a hidden lump—each resource teaching BSE as a life-saving personal responsibility. Seems to make sense. In reality, there is no scientific evidence to prove this is true…Many organizations share NBCC's viewpoint on BSE. The National Cancer Institute (NCI) no longer prints a BSE guide."
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