Why Self-Exams Aren’t Enough

A self-examination(SELF IG-ZAM-IN-A-SHUN) — Using your hands to feel for abnormal tissue in your breast is when you feel for abnormal tissue(AB-NOR-MOL TISH-YOU) — The accumulation of cells that aren't supposed to be there in your own breast. This is a simple and easy test that you perform on yourself. While self-exams(SELF IG-ZAMS) — Using your hands to feel for abnormal tissue in your breast can be done periodically (every month), they will likely only find a large mass(MAS) — An abnormal growth or tissue. The smallest mass(MAS) — An abnormal growth or tissue you can feel is usually about an inch, like the size of a large grape.

As a result, even if an abnormal mass exists, most women who perform self-examinations(SELF IG-ZAM-IN-A-SHUNS) — Using your hands to feel for abnormal tissue in your breast won’t be able to feel a mass.

Your doctor can also perform an examination (referred to as a clinician examination(KLIN-ISH-SHUN IG-ZAM-IN-A-SHUN) — Medical professional feeling for abnormal tissue in the breast) of the breast (usually every year), but your doctor will still have the same problem. They also cannot feel a small mass.

yellow phone next to a couch
Are you surprised by this? If so, you are not alone. 

To help you understand why it’s so hard to find abnormal masses through self or clinician(KLIN-ISH-SHUN) — A doctor, nurse, or medical care provider exams, imagine having a bag packed full of packing peanuts. In this bag, there is one large grape, and it is your job to find it by blindly feeling the contents of the bag from the outside.

A bag full of packing peanuts is very similar to a woman’s breast. Breast tissue is quite lumpy, and finding the mass, or grape, is very difficult. Sometimes a breast mass can feel a little harder or be painful, but most of the time there is very little difference. Normal breast tissue, benign(BE-NINE) — A growth in the body that is neither invasive nor cancerous and has a very low risk of spreading masses, and breast cancer can all feel the same.

For women who have large or dense(DENSE) — Tissue that is firm and hard to compress (firm) breasts, finding masses through self-examinations(SELF IG-ZAM-IN-A-SHUNS) — Using your hands to feel for abnormal tissue in your breast can be even harder. As the size and the fullness of the breast increases, it becomes more difficult to find a mass. Similarly, the bigger the bag or the more peanuts packed into the bag, the more difficult it is to find the grape.

field of flowers
Many women feel guilty about not being able to find an abnormal mass earlier, but it is not their fault.

Self-examinations(SELF IG-ZAM-IN-A-SHUNS) — Using your hands to feel for abnormal tissue in your breast and clinical examinations provide only a small benefit for breast cancer patients.1,2 In fact, you may be even more surprised to learn that self-exams(SELF IG-ZAMS) — Using your hands to feel for abnormal tissue in your breast and clinical exams are not recommended screening tests(SKREE-NING TESTS) — A procedure used to discover a disease at an early stage on some national guidelines. However, since self-exams(SELF IG-ZAMS) — Using your hands to feel for abnormal tissue in your breast are not harmful to do, and they can help some patients, we suggest continuing to do them every month. 

So how can you spot breast cancer early? You need better screening tests(SKREE-NING TESTS) — A procedure used to discover a disease at an early stage.

The most common form of screening(SKREE-NING) — Using a test to find a specific disease or condition at an early point in the course of a disease for breast cancer is a mammogram(MAM-O-GRAM) — A screening test that uses x-rays to look for breast cancer. Mammograms(MAM-O-GRAMS) — A screening test that uses x-rays to look for breast cancer are well-proven to find breast cancer early and can improve your chances of beating breast cancer if done regularly.

A mammogram(MAM-O-GRAM) — A screening test that uses x-rays to look for breast cancer, in case you haven’t had one, is an x-ray(EX-RAY) — Energy particles that pass through tissue to obtain an image of the body of your breast. Doctors use the x-ray(EX-RAY) — Energy particles that pass through tissue to obtain an image of the body to tell the difference between normal and abnormal breast tissue, allowing them to spot abnormal tissue(AB-NOR-MOL TISH-YOU) — The accumulation of cells that aren't supposed to be there that is much smaller than a grape.

Mammograms(MAM-O-GRAMS) — A screening test that uses x-rays to look for breast cancer are like standing in a lush garden, searching for a single dandelion among many normal flowers. Sometimes you will miss a single dandelion hiding under another flower. Mammograms(MAM-O-GRAMS) — A screening test that uses x-rays to look for breast cancer, unfortunately, are not perfect, missing an average of 16% of cancers.3 These unseen masses are sometimes the ones found through self-examination(SELF IG-ZAM-IN-A-SHUN) — Using your hands to feel for abnormal tissue in your breast.

watercolor illustration of grapes

So, please get your mammograms(MAM-O-GRAMS) — A screening test that uses x-rays to look for breast cancer when they are recommended. And if you do find a hard or growing mass in your breast during a self-examination(SELF IG-ZAM-IN-A-SHUN) — Using your hands to feel for abnormal tissue in your breast, see your doctor.

Finally, remember breast cancer just happens and sometimes even in the young and unexpected. Read our book, How Breast Cancer Is Like a Dandelion to learn more about breast cancer high-risk factors, prevention options, and screening(SKREE-NING) — Using a test to find a specific disease or condition at an early point in the course of a disease.

And, if you, unfortunately, know someone who has been diagnosed with breast cancer, be a Girlfriend In Action. Help her through this difficult time by passing this book onto her, giving her a place to start and a guide through her journey.

References
  1. Thomas DB, Gao DL, Ray RM, et al. Randomized trial of breast self-examination in Shanghai: Final results. JNCI Journal of the National Cancer Institute. 2002;94(19):1445–1457. doi:10.1093/jnci/94.19.1445.
  2. Semiglazov VF, Mikhailov EA, Manikhas AG, et al. Final results of Russia/WHO prospective randomized trial of breast self-examination (1985–2003). European Journal of Cancer Supplements. 2004;2(3):87. doi:10.1016/s1359-6349(04)90712-4.
  3. Performance Measures for 1,838,372 Screening Mammography Examinations1 from 2004 to 2008 by Age -- based on BCSC data through 2009. Breast Cancer Surveillance Consortium. http://breastscreening.cancer.gov/data/performance/screening/2009/perf_age.html. Accessed February 14, 2017.
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