Are breast self-exams a thing of the past?

We’ve all heard inspiring stories from breast cancer survivors who discovered their own cancer. According to the National Health Interview Survey, up to 25% of women detected their breast cancer through breast self-examination. In comparison, 18% found it by accident. Despite this, the American Cancer Society (ACS) no longer recommends breast self-exams (BSE).

Does this mean BSEs have lost their value? Not quite.

Breast self-awareness versus breast self-exam

According to Dr. Reema Batra, a Sharp Community Medical Group board-certified oncologist affiliated with Sharp Grossmont Hospital, the shift is because self-exams have not proven to be an accurate enough screening study. “Very small abnormalities could easily be missed without an imaging study to correlate,” she says.

In other words, a BSE is no substitute for a screening mammogram, which remains the most effective method to screen for breast cancer. Research has also shown that BSEs have not helped reduce breast cancer deaths.

In some instances, BSEs may also give women a false sense of security. If nothing unusual is detected, they might be less likely to schedule a regular mammogram. On the other hand, if a woman believes she feels something abnormal, it can lead to anxiety and a flurry of appointments made in panic.

Instead, health care experts and the ACS recommend that women be self-aware of how their breasts usually look and feel. Any changes should be reported to a health care provider immediately.

Dr. Batra says it’s essential for women to familiarize themselves with their breast tissue. That way, it’s easier to notice when something new has developed. “Often, women will have cystic breast tissue, which could feel like lumps,” she says. “It's important to know what your breast tissue feels like, and if there is a change or something new, your doctor should be alerted.”

Some of the things women should take notice of are new lumps, skin changes such as an orange peel-like appearance, sudden swelling or bloody nipple discharge.

Do breast self-exams still hold value?

There are exceptions when BSE could be helpful. But again, the idea is to become familiar with your breasts.

“Breast self-exams may be helpful if you're at high risk of breast cancer,” Dr. Batra says. “They may also provide peace of mind if you're in an age group — under 40 — in which annual mammograms aren't recommended.”

Dr. Batra also notes that mammograms are typically done yearly. If a woman detects a lump or something out of the ordinary in-between her appointments, she should contact her doctor, as cancer may have developed in the interim.

“Mammograms are not perfect tests,” Dr. Batra says. “For example, if a woman has dense breasts, a mammogram may not detect a tumor. So, practicing self-exams could potentially be helpful.”

What are the current breast cancer screening guidelines?

Beginning at age 40, start a conversation with your doctor about routine breast screening. Discuss when screening should begin and what type is best for you based on your risk factors.

The ACS offers the guidelines below for women at average risk. A woman is at average risk if she has no personal history or strong family history of breast cancer, has no genetic mutation known to increase the risk of breast cancer, and has not received chest radiation therapy before the age of 30.

Women between 40 and 44 have the option to start screening with a mammogram every year.

Women 45 to 54 should get a mammogram every year.

Women 55 and older can switch to a mammogram every other year or choose to continue yearly mammograms. Screening should continue if a woman is in good health and is expected to live at least 10 more years.

All women should understand what to expect when getting a mammogram for breast cancer screening and what the test can and cannot do.

“The most important things you can do to reduce your risk of breast cancer is consistent mammography screening and talking with your doctor about how to reduce your risk,” Dr. Batra says.

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