The Effect of Breast Self‐examination on Early Detection and Survival

Kuroishi, Tetsuo; Tominaga, Suketami; Ota, Jun; Horino, Toshio; Taguchi, Tetsuo; Ishida, Tsunehiro; Yokoe, Takao; Izuo, Masaru; Ogita, Masami; Itoh, Sueyoshi; Abe, Rikiya; Yoshida, Kôichi; Morimoto, Takahiro; Enomoto, Kohji; Tashiro, Hideya; Kashiki, Yoshitomo; Yamamoto, Satoru; Kido, C; Honda, Kotaro; Sasakawa, Michizou; Fukuda, Mamoru; Watanabe, Hiromu

doi:10.1111/j.1349-7006.1992.tb00113.x

Cited by 19 publications

(13 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Relative risk of having advanced breast cancer in BSE vs non-BSE groups Practise BSE vs do not practise BSE Foster, 1984Huguley, 1988Kurebayashi, 1994 All All Koibuchi, 1998Kuroishi, 1992Greenwald, 1978Owen, 1985Ogawa, 1987Tamburini, 1981Feldman, 1981Smith, 1985Smith, 1980 Cancer found by BSE vs found by chance 0.60 (0.46 −0.80) 0.66 (0.44 −1.01) Figure 2 Observational studies of women with breast cancer, comparing the rates of advanced breast cancer between the BSE and non-BSE groups. A test for heterogeneity between the studies yielded a P-value of o0.001 for those studies based on women who practise BSE and a P-value of 0.051 for those based on finding cancer by BSE.…”

Section: Resultsmentioning

confidence: 99%

“…Again there was no strong evidence of heterogeneity between the results (P ¼ 0.26). If the study (Kuroishi et al, 1992) in which some women had mass screening is excluded, the estimate is not much changed the pooled relative risk is 1.00 (95% CI 0.85 -1.18, P ¼ 0.98). Figure 2 shows the relative risk of having advanced breast cancer in women who practise BSE compared to those who did not, among all women newly diagnosed with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on women newly diagnosed with breast cancer A total of 15 studies were based only on women newly diagnosed with breast cancer (Greenwald et al, 1978;Smith et al, 1980;Feldman et al, 1981;Tamburini et al, 1981;Foster and Costanza, 1984;Owen et al, 1985;Smith and Burns, 1985;Ogawa et al, 1987;Huguley et al, 1988;Kuroishi et al, 1992;Le Geyte et al, 1992;Kurebayashi et al, 1994;Auvinen et al, 1996;McPherson et al, 1997;Koibuchi et al, 1998) and they were divided into four groups based on two different measures of outcome and two different measures of exposure.…”

Section: Methods Data Sources and Study Selectionmentioning

confidence: 99%

“…In one study (Koibuchi et al, 1998), all women had a clinical examination as part of a massscreening programme. A difference between the BSE and non-BSE group was reported with respect to mammography use in one study (18% in the BSE group compared to 7% in the non-BSE group, Huguley et al, 1988) and mass screening by clinician examination in another study (37% in the BSE group and 21% in the non-BSE group, Kuroishi et al, 1992); analyses were performed both with and without these two studies.…”

Section: Methods Data Sources and Study Selectionmentioning

confidence: 99%

See 3 more Smart Citations

Breast self-examination and death from breast cancer: a meta-analysis

2003

View full text Add to dashboard Cite

Breast self-examination (BSE) is widely recommended for breast cancer prevention. Following recent controversy over the efficacy of mammography, it may be seen as an alternative. We present a meta-analysis of the effect of regular BSE on breast cancer mortality. From a search of the medical literature, 20 observational studies and three clinical trials were identified that reported on breast cancer death rates or rates of advanced breast cancer (a marker of death) according to BSE practice. A lower risk of mortality or advanced breast cancer was only found in studies of women with breast cancer who reported practising BSE before diagnosis (mortality: pooled relative risk 0.64, 95% CI 0.56 -0.73; advanced cancer, pooled relative risk 0.60, 95% CI 0.46 -0.80). The results are probably due to bias and confounding. There was no difference in death rate in studies on women who detected their cancer during an examination (pooled relative risk 0.90, 95% CI 0.72 -1.12). None of the trials of BSE training (in which most women reported practising it regularly) showed lower mortality in the BSE group (pooled relative risk 1.01, 95% CI 0.92 -1.12). They did show that BSE is associated with considerably more women seeking medical advice and having biopsies. Regular BSE is not an effective method of reducing breast cancer mortality. British Journal of Cancer (2003) For many years, women have been taught methods of breast selfexamination (BSE) and it is recommended that they practise this regularly (Boyle et al, 1995; Shapiro et al, 1998), usually every month. There is a belief that among women who practise BSE, those who develop breast cancer are more likely to find it at an earlier stage and this is expected to lead to earlier treatment and hence decrease their risk of dying from the disease. Breast selfexamination is appealing as a routine screening method because the examination has no financial cost (apart from the initial instruction sessions) and can be conducted in private. Most studies on the effectiveness of BSE have been observational. They suggest that women who practise BSE are more likely to find their breast tumour themselves, that the tumour tends to be smaller and that these women have an increased survival (Hackshaw, 1996; International Agency for Research on Cancer (IARC), 2002). However, survival time as an outcome measure can be misleading because of lead-time bias, in which BSE only identifies cancers at an earlier stage but has no effect on prognosis. Using mortality rates instead of survival time can overcome much of this bias.Recently, the International Agency for Research on Cancer (2002) published a review on breast-cancer screening that reported the individual results from observational studies of BSE in relation to survival and stage of cancer, and those from randomised trials and cohort studies in relation to mortality. We here, however, present a meta-analysis of BSE and breast-cancer mortality by reviewing the published evidence from both observational studies and randomised trials, including t...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methods Data Sources and Study Selectionmentioning

confidence: 99%

Section: Methods Data Sources and Study Selectionmentioning

confidence: 99%

See 2 more Smart Citations

Breast self-examination and death from breast cancer: a meta-analysis

2003

View full text Add to dashboard Cite

show abstract

“…It is estimated that 75-90% of all breast cancers are found by women themselves (7) even though most women do not examine their breasts (13), and BSE is not as sensitive or specific as mammography. Some studies have demonstrated that BSE finds tumors at an earlier stage than those found by chance (14), is an important adjunct to screening mammography for finding interval cancers (15), finds tumors not visible on mammography (16), and reduces breast cancer mortality (17,18), while other studies did not produce evidence that BSE found cancer early (19) or reduced mortality (20,21).…”

Section: O N F L I C T I N G E V I D E N C E R E L a T E D T O B S mentioning

confidence: 98%

Commentary - Evidence Against Breast Self Examination is not Conclusive: What Policymakers and Health Professionals Need to Know

Kearney

Murray

2006

J Public Health Pol

View full text Add to dashboard Cite

Breast cancer is a serious health concern and a disease that is not well understood. Early detection remains the best way to prevent debilitation and death. Traditionally, mammography, clinical breast examination (CBE), and breast self examination (BSE) have been accepted as legitimate breast screening modalities. Over the past 5 years, academics, health professionals, and policymakers have seriously questioned the usefulness of BSE after influential organizations such as the Canadian Task Force on Preventive Health Care downgraded their BSE recommendation citing fair evidence of no benefit and good evidence of harm. We briefly review the three large BSE trials, highlighting methodological weaknesses limiting their ability to evaluate its effectiveness, as well as critique the 2001 Canadian Task Force on Preventive Health Care report on BSE. We argue that it is premature to conclude that BSE is ineffective. Given that most women find their own breast cancer, this article cautions policymakers and health professionals that a prudent approach to BSE promotion should be taken.

show abstract

Method of tumor detection influences disease-free survival of women with breast carcinoma

Senie

Lesser

Kinne

et al. 1994

Cancer

View full text Add to dashboard Cite

Background. Screening mammography provides the primary means of reducing breast cancer mortality. Clinical breast examination (CBE) and breast self‐examination (BSE) may be complementary screening modalities enabling palpation of interval cancers and detection of tumors not visualized by mammography; however, their combined contribution to improving prognosis has not been evaluated adequately. Methods. Disease‐free survival was assessed in relation to method of tumor detection among 729 consecutive patients treated by mastectomy and axillary dissection for primary breast carcinoma between 1976 and 1978. Results. Disease‐free survival at 10 years was significantly higher after detection by mammography (77% of 30 patients) or CBE (78% of 101 patients) compared to self‐detection (64%). The hazard ratio of recurrence associated with clinical examination or mammography in contrast to self‐detection was significantly reduced to 0.55 (95% CI, 0.37–0.81; P = 0.001). In addition, annual CBE, compared to less frequent clinical palpation, reduced the risk of recurrence controlling for detection modality (P = .03). In multivariate analyses, the method of detection and frequency of clinical breast examination remained statistically significant prognostic factors after controlling for number of screening mammograms, history of prior breast surgery, family history of breast cancer, and age at diagnosis. Differences in self‐examination frequency were not associated with prognosis. Conclusions. Among patients diagnosed before widespread mammography screening, tumor detection by CBE was associated with a significant reduction in recurrence compared with detection by self‐palpation. Improvement in the frequency and quality of CBE and BSE may enhance the contribution of these modalities to early detection, complementing the role of screening mammography in reducing breast cancer mortality rates.

show abstract

The Effect of Breast Self‐examination on Early Detection and Survival

Cited by 19 publications

References 14 publications

Breast self-examination and death from breast cancer: a meta-analysis

Breast self-examination and death from breast cancer: a meta-analysis

Commentary - Evidence Against Breast Self Examination is not Conclusive: What Policymakers and Health Professionals Need to Know

Method of tumor detection influences disease-free survival of women with breast carcinoma

Contact Info

Product

Resources

About