For Breast Self-Examination, Once A Month Is Quite Enough

March 22, 1999

Too much breast self-examination can be counterproductive for women with a family history of breast cancer, according to a team of British scientists. Not that monthly breast self-examination isn't an effective way of detecting early symptoms of breast cancer for women with a family history of the disease. More than 90 percent of breast cancers are found by women themselves, some studies show.

But examining one's breasts every week or every day does not improve detection of symptoms; it may in fact reduce the efficacy of the procedure, according to a report in the March issue of Psychosomatic Medicine.

"Women who over-examine may be substituting frequent yet cursory self-examinations for thorough and effective ones," says Kate Brain, Ph.D., of the University of Wales College of Medicine, who led the research team.

"Excessively frequent self-examination can also make early detection of breast cancer symptoms more difficult by increasing the likelihood of false-positive findings," Brain says.

The researchers, who also included Sheffield University psychologists, surveyed 833 women who have family histories of breast cancer. About 18 percent said they examine themselves for breast cancer daily or weekly. Fifty-six percent reported that they follow the recommended frequency of once or twice a month. At the low end of the spectrum were 26 percent of the at-risk women who rarely or never examine themselves.

Some earlier studies suggested that those who rarely examined their breasts were hindered by fears and anxieties. However, the Wales/Sheffield scientists found that cancer-specific anxiety was lowest among the women who examined themselves least often and highest among those who examined themselves most often. High general anxiety was found only among the hyper-vigilant women who examined themselves daily or weekly.

Current health promotion efforts seek mostly to alert and motivate at-risk women at the low end of the self-examination scale. For the high-end self-examiners, these programs need to be broadened to include the message that daily or weekly examinations may not improve cancer detection, the researchers said.

"A delicate balance needs to be achieved between managing anxiety and maintaining optimal adherence to breast self-examination," they conclude.
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, MD, editor-in-chief, at 619-543-5468.

Posted by the Center for the Advancement of Health For information about the Center, contact Petrina Chong, 202-387-2829.

Center for Advancing Health

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