2. ;breasttestfailing?
Self-examsdon'tsave
BREASTCANGERSCREENING lives,studiessay,but
othersthinktheystill
belongineverywoman'
anti-cancerarsenal
By Mariko Thompson I staflwriter
latestguidelines
)AmericanCancerSocietyreleased
cancerscreeninqguidelines.The
lromthe1997and2003quide'
Erccommendationforbreaslself-
BSE.Thepracticehadlonqbeen
nlegralpartofearlydeiection
ng-term,larg€scalestudyreleased
irmedthalBSEwasnotetfectivein
athrate.TheAmericanCancer
itsguidelinesapproxmalelyevery
countlornewscienliliclindin0s.
oldandnewguidelinescompare:
phy
ilr on:Annuallyslarlingatage40.
tdalion:Nochange.
asteram
dation:Everythreeyearslor
to39,annuallyforwomenage40
Idalion:Nochange.
lxamination
ittlor: Monthlystarlinqatage20.
dation:Eeginninqinlhoir20s,
brtoldaboutthebenofitsandlimi"
'Iti! acceptableforwomefilo
loBSEortodoitoccasionally.
Ieportanybreastchanospromptly
]lreprovide..
|nandwomenwithserious
lems
dation:I!!orer€searchisn€eded.
ndailon:Continueannualmam-
ardlessofage,aslonqasawoman
serious,chronich€althprobems.
hserioushealthproblernsorshort
,evaluateongoinoearlydeteclion
iirrlobaathighrisk
dtllon:womenwitialanilyhis-
€ocershou'ddiscussguidelines
trs.
idallon:womenknowntobeat
lraybonelitfrominitiatingearly
'atayounoerageaind{romaddF
riasbreastultrasoundorMRI-
Howtodo
abreastself-exam
Step1:Whilelyingdown
Feeforahardlump,
thickeningoranychange
inyourbreasltrssue.
I Liedownonyourback
wilhapillowund€ryour
ightshoulder.
I tlseth€padsofthe
threemiddleing€rson
yourletthandtoexamine
yo!r|ightbreast.
I Pressusin0liqht,
medi!mandfirm
pressure;followan
up-anddownpattern
I Repeaionyourielt
0reasl
Step2:Whilestanding
ii lront0lmiror
Lookforchanqesnthe
snape,sze0rappearance
ofyourbr€ast.Inspect
yourbreastinloursteps:
I Holdrngamsatsides
or years.advocatingthrl womendo monthly breast
self'exnminations.or BSE.to dcl.cl susptcrous
changcsscemedlike a logicalcourseof actnD. lf ca y
detectionof breastcanccrimprovedthe oddsofsurvival.
thcn women performing the self cxam should inrprovc thcir
oddsof eslv detection.
But scien;edoesn'tdwrys upholdwhal lppears logical
Recenlly,rescarchhasdernotedBSE l;om i1splacein thc
earl)derclion lrinrll.hhhrl.o in(lud
-
rnnu,l n,Jmmog
rrth) ..r<ning' .rrrLrrrfJr rce r0JnJ rrrrrurlhr<dne.m
peribrmedbr a doclor.
''Thcre'sno datato supponBSE thc way il's been
dcscribedandpushedheavilythrnrgh the years,which ts
ou do ir .u ft;qu(nrl rharvoulno$ Jll rhcinlncacie.ol
iour lrea.r.
-il
nr. ctrn.i Ru*cll. a.pul('$",nrn r.,r
theAmericanCancerSocjeiyandco direclorofthc Lce
BreastCcnlerat the USC Noms ComtrchcnsiveCancer
ln Octobcr,researchersfron the FredHurcbirson Cancer
RcseaJchCenterin Sca le releasedrcsullsfrom a long'lc'4
large-scalesludythallbund lcachingBSE did not rcduce
dealhsftom breastcrncer.ll wasnt tbc only sludylo cast
doubl on the uscfulnessot'BSII. but i1ssizeard scopegav€il
hefi. ln M,y. fie AmericanCnncerSocietyreviscdits breas
ceccr screeningguidclines.where wontn over 20 were
oncetold to do BSE monlhly.thc rmericanCancerSociety
now savsthe self-examk oplionnl.
In otilerwords,tsSEdoesnl hutt. But don l couni on it 10
help.
Lookinglorward
Mosl studiesofBSE havebeendoncrelrospectively.ask-
ins breastcanccrpatientswhethertheyhadpedormedsell_
ex;ns. The ftcd Hulchinson Clncer ResearchCcnter sludy.
lundedby a qranttiom the NntionalCanccrInsdtule.looked
forward. iollownrs nore lhar 260,000 women in Shanghai.
China,fbr l2 years.Becauscscreeningmammographyisn't
avaihble there.resercherswantedto sccif leachingBSEto
women would rcduce the breast cancer monality ratc
Padicipanrsweredividedcvenlyinlo a controlgroup and,
Afourlhrt sa uarnedin BSL lhe qorncnIn Lht8St grou
ard rhecam lour Io five rrme.d ) er und(r mrdr rl {p(n'r'
sionandalsorcccivedmonthlyreminden to do so al home
Afler 10io ll years,the dead ralesin both grouPsremame
rhe.ame,'aid Dr. Drtid Thomr'. rh( l(ad ineri8 .r'
'I heBSk I'oup drdlrndmo'J lump.rh3rhrJ Io b<biop-
'red.
Thi' rdsed rhenumbero[ henrsnbreasrdr.ea.ecr'c'
but not the numberof cancers,Thomassaid
"lf fewer wornen (in lhe BSE group) h:td died of breast
cdccr, you could sayit waswodh it," Thomassaid."But
since$ere was no beneiit.lhescbiopsieswe would saywe(
Thomas said the findings show that developing countries
E
I Holdinqarms
overnea0.
I Pressinghandsonhips
loli0htenchestmuscLes.
I Bendinqforwardwth
handsonhips.
3. chd ohe schm d Maybach/slafi PhoroEaph€r
"You wantto useanytool
available.That'stheway
to beirtit, throughearly
detection."
MaryPetersen,picturedwilhdogTia
Pele6enisa SanlaClaritabreastcancer
survlvorwhoinadvedenllylounda lump
whileintheshower.
ue ncrrLr"ll nlJinPtherrlimit(dre.our.(' inr"
crcnlinsmedi;al inf;astrucrureandcnsuringtha(
*omen hare accessto carerathcrthanterching
BSL.ln'hc | .S..$h{r. Inimn,nSraph}i. wiJe
sDread.BSE still liasa fole to play.hc said.
women, prnicularly thoseconsideredhjghrisk
lbf hrc!$ canccr,may wanl to supflementthcrr
annualmammoqramswilh self_cxrms.
'lfa wonan is highly notilrted, go xhead
andpr3crceit." Thomassaid. Rcmember,yotr
ha!; ro do r bede.iob andbe conscientious
You nu! endup liavinSa biopsythaasnoi
goirq ro bc cnnce..'
' A; csrnn cd 40.000Amcrican wonen dic ot
breancdccr each1cu. The risk ol breaslcan-
cer urcrcasessitlr ise. Iror,t -1o-yerrold wotn
:,.,.'hr.'lh 'r l
'.l"fin,
l'r(J'r l.rn(erocr rh(
neal l0 vcalsis I in 2,19.t r ! 70'yer old
{omrn._(hefisk ilcreascsto I in 2:1.according
1irthc Anr.ricar Cdccr Society.
Both lhc NatnnralCancerlDslituteud |he
ADrerican(lrncer Societ) reconrmerdregulrr
rnrmmogrnrs i)r womenocr rhergc ol '10.
Accodjng ro lhe Nltional Canccrlnstllutc.
rb()utl0 pcrcenlol mamrnogr:rmsthal co e ul
nc{rd!e havem'ssedcaDcers.
SantaClarih residcnlMary Pctersenis con-
cer.ed thrl nrakingBSFIofti()nxl will mean
nrissedcxnccrs.Peterscn.39, in.drcnearli
,,rn,'J t' r'rl r'rh.r h.c
'{
r hrlr 'r '.v ( r'i l:'
ffis-agoSecause hermotherhadbreasican
ccr.Petersenhadreliedonregularmammo-
arams.Her lastonehadcomeup negatile
-
Thc lump tumed oul to be a malignanttumor'
Pctersenunderwent two surgcries and radiation
reatment. Today she is cancer free. still. she
$"n,lcr. il shenxchl hae caughtlhe lum'{ ear-
lier had sheperfomed a monthly sclfexam.
You $dni to u.ee) ruolaar'Jble.Pcr.r'en
said."That's the way to bcatit. tlr]onShearly
The Anerican Cancer Society recommenda
tion stressesthatwomenshouldbe lamilirr with
ihe renain of their heasts. cven if they op| not to
do the self exam.Cheryl Kidd, the SusanG.
Komen Breast Cdncer Foundrlion s director of
education.saysthebestway for a woman to
havethatknowledseis by doingBSE every
"We know BSE does not improve monaliry. '
Kidd said- "There s another side of the story' It
canhelpa wo'nanempowerherself Ir hcLpa
wornanleamher body undLonmuni(a(e with
Dr. Ken Munay, who runs a family practice in
Nonh Hollvlvood. said he continues to trarn
female Dad;nts on how to pelform BSE
"I haie ar uneasinesswith abandoning the
pra,ricealtogerhe'.hesard All ol u.0 ph)'i-
cidnshve the exDenenLeol patlenNwno ols
covered lurnps ttiat tumed oui to be cancer."
Keepintouch
The majorir)ofw"men wrlhnc8ariem!m
m"pramswho find therrown tumoF rlprcally
do io in the samemanner that Petersendid
not rhrouah a trained self-exam, but by touching
lheir beaits in ihe shower or while dressrns,
Russell said. That's why the American Cancer
Society reconrmends"self awareness"- that
women be familiar with how their breastsnor-
mally feel and report any changesto their doc-
Thegurdelrne'also.uSg(rfiJr $umen$r$
family histoq go to screenrnStl'nrcs rn.r spe-
.,alrle in brcJnc e.Theeuomcn .dn hemon
itored more frequenlly and receive additional
tesrs. such asa breast ultrasound or MRl, Rus
sell said.
A 'econdmembcrol thcedrlydcreclionmnrr.
mav take a hir down the road as well. There are
quiuonc0boutIheeitectren€sofrhe LlrnicaL
bre$t cram. {incc a docmLwho perlormslr
onceayed isn't likely 1onoticesubtlechanges
Russellsaid.
However,the clinicalexan providesothcr
benefits.lt s an oppo(unit) Ior doctorJnd
prticnrrodrs.ussbreadhealrhAnd rt canhe
useful if perfomled iust prior to fte scrcening
manmoararn.shesaid.
''l1 so;ethiDg doesnt lecl righ(.the namnro
!r.m {ill nn Innr(r r'er (reenrn!mdnxnnBram
Eurr drrunosrrcmunrm"qrrm, Ru(iell dJ lr
$rll heeialurLLdIn 3,lr{icLentrAhr,wrrhcun
cenlrationin theareathatneedsto be lookcctat a
litde nnre closely.
tir healtheduca!ffsanddoctos. Lts much
.asierto senda messlgewith one_sjzcfils_xll
instructio s. But in the.ealm ofbrcrslcancer
rnd earlydclectioo,scier[ific researchisnow
reqniringthatthoses'mple lressagcsglve wrv
tr)morc nuanceootscuss(trs.
''BSE still hrs. pla... but it s moreresticlccl
ros lh.ma' .drd t. k,rns $har$e.u, and
Marko Thonrpson.(316)715_3620
marko.1h!npson@r.iairt'newscom