Usefulness of Breast Self-Examination for an Early Detection of Breast Cancer. Results of a Study on 500 Breast Cancer Patients and 652 Controls

Abstract

The knowledge and practice of breast self-examination (BSE) was investigated among 500 women with operable breast tumors between 35 and 64 years of age (all successively operated) and 652 healthy women, matched with the previous group for 5-year age groups from 35 to 54 years. Only 39.9% of breast cancer women and 34.5% of the controls practiced BSE, starting from 45 years, and it is used less frequency by the women with a poor education and those in a lower economic bracket. Among the 500 breast cancer patients, those who practiced the self-examination had a higher number of tumors with a diameter no greater than 2 cm and a lower number with a diameter larger than 4 cm. In addition, in this group the percentage of unaffected axillary lymph nodes (N-) was 58.8% compared to 48.8% for the group that did not practice self-examination, and the percentage of the cases with more than 3 metastatic lymph nodes (N+ greater than 3) was 20.0% in the first group and 27.3% of the second one. These differences were statistically significant. The correlation between tumor diameter and the histologic lymph node stage is equally evident, since there is a progressive reduction in N- cases and a contemporary progressive increase in N+ (greater than 3) cases with increasing breast tumor diameter. Therefore, we can infer that the lack of practice of BSE causes a diagnostic and therapeutic delay, which is responsible for aggravation of the prognosis.

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

“…Several studies have shown that various characteristics that are likely to be associated with dying from breast cancer were also associated with BSE practice, but analyses adjusting for the potential effect of such confounding on mortality were not reported. Women who practised BSE tended to be younger, premenopausal and of a higher socioeconomic status (Smith et al, 1980;Feldman et al, 1981;Tamburini et al, 1981;Huguley et al, 1988;Le Geyte et al, 1992;Auvinen et al, 1996). Much of the reduction in mortality observed in these studies might therefore be explained by a combination of these and other confounding factors as well as the aforementioned biases, rather than a real effect of BSE.…”

“…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.…”

“…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.…”

“…It was monthly (Ogawa et al, 1987;Auvinen et al, 1996), monthly or several times a year (Feldman et al, 1981;Tamburini et al, 1981;Foster and Costanza, 1984;Koibuchi et al, 1998) or at least two (Smith and Burns, 1985) or three (Smith et al, 1980) times per year. In several studies, about half or more of the women in the BSE groups had reported that they checked their breasts monthly (Feldman et al, 1981;Smith and Burns, 1985;Ogawa et al, 1987;Le Geyte et al, 1992).…”

Self-Examination of Thyroid Nodules.

“…Breast self-examination (BSE) has been widely used for the screening of breast carcinoma [5,6]. Further, self-examinations of oral, facial, skin, and testicular carcinomas have been reported [7][8][9].…”