The role of breast self-examination in early breast cancer detection

Breast self-examination is a non-invasive, simple early-screening method for the detection of breast cancer. In Germany clinical breast examination and training for breast self-examination are part of a public early cancer detection program for women 30 years and older. Generally women have accepted breast self-examination as a means for early detection of breast cancer, but only 8-40% of women conduct it once a month. Recently, the Canadian Task Force on Periodic Health Examination excluded breast self-examination instruction from periodic health examinations, because the results of two large randomised controlled trials in Shanghai/China and in St. Petersburg/Russia, a quasi-randomised trial in Great Britain and a large cohort study in the United States have failed to show a reduction of mortality from breast cancer. A Canadian case-control study was unique in its prospective, objective assessment of self-examination practice. Specific aspects of technique were found to be associated with a reduced risk of death from breast cancer. This trial suggests that proper education in a standardized and evaluated breast self-examination technique might be an important factor in breast cancer prevention. Several studies examined the impact of psychological factors on breast self examination practice. They describe that worry and anxiety can motivate and inhibit self-protective behaviour. Few studies have examined the psychological effects of breast self-examination, that might be of particular interest for further research.