Breast self-exams don't save lives

[deez nuts]

BREAST SELF-EXAMINATION, a detailed procedure that calls for women to periodically search carefully with their fingers for a thickening or lump that could signal cancer, has been promoted as a way to help detect cancer at an earlier stage and, thus, save lives. The technique has been promoted especially in developing countries where X-ray mammography is not readily available.
But a decade-long study of more than 260,000 women in Shanghai suggests that breast self-examination does not lower the risk of death from breast cancer. The study appeared Wednesday in the Journal of the National Cancer Institute.
“In developing countries, where mammographic screening is not available, it would not seem to be a good use of the limited funds available for preventive services to promote the practice of BSE,?the study says.

http://www.msnbc.com/news/815581.asp#BODY


Edit: after reading this from a medical journal at the medical library and finding the news story on MSNBC, the research itself kinda disturbed me.

In the study, researchers randomly assigned 266,000 women factory workers in Shanghai to one of two groups. Women in one group of 133,000 were all trained to perform BSE properly. They also received monthly reminders to do the exam and then practiced the exam under medical supervision every six months for five years. The other group of 133,000 received no information on breast cancer screening.
???Thomas said that after more than a decade the researchers found there was no difference between the two groups in the rate of death from breast cancer.

That in my opinion is one hell of a risk to take.

And to say that BSE is useless is a bold statement to make considering the whole purpose of the BSE is self-diagnosis and prevention. Sheesh, gotta love the research folk up at the NCI.



<!--EDIT|Chasiubao_Boy|Oct 27 2002, 07:05 PM-->

[SunWuKong]

Women who performed the BSE did find more benign lumps that required medical attention, but there was no reduction in the rate of breast cancer, he said.

i am not too familiar with breast cancer. is there a difference between "benign lumps" and breast cancer?

[deez nuts]

Originally posted by SunWuKung@Oct 1 2002, 07:25 PM

i am not too familiar with breast cancer. is there a difference between "benign lumps" and breast cancer?

Yes MK. A benign lump may become malignant or it may not become malignant. Breast Cancer is basically a malignant lump.

[amietron]

so, how old're you supposed to be when you first start getting those? and how often should you get examined?

[amietron]

Women over the age of 18 should do a Breast Self Exam once a month a couple of days after their period. If you have irregular periods just do it on the same day of every month. I normally tell women patients if they have irregular periods to do it on the day that matches the day of their birthday.

I suggest doing a mammogram once a year after 21 and twice a year (once every 6 months) after 35. Twice a year especially after menopause.

Like with most cancers, early detection is key to early prevention to prevent the onset of malignancy and possible spread of the cancer.


How to do a Breast Self Exam:

http://trfn.clpgh.org/bcis/GeneralInfo/bse.html

Get your partner involved too, I'm sure there will be no objections on their part!

Edit: or Holla back, I'll be more than happy to do it for you, if you around my way!

Edited by Chasiubao_Boy - Sep 30 2002, 10:22 AM

nevermind. found the answer.

[SunWuKong]

Originally posted by Chasiubao_Boy@Oct 1 2002, 07:38 PM

Yes MK. A benign lump may become malignant or it may not become malignant. Breast Cancer is basically a malignant lump.

so as i understand it, what necessitate the conclusion to be drawn is that not a big enough number of benign lumps found by BSE become malignant such that BSE is worth spending money on?

but what i really want to know is how often were the other group of women given clinical examinations.

[deez nuts]

Originally posted by SunWuKung@Oct 1 2002, 09:15 PM

but what i really want to know is how often were the other group of women given clinical examinations.

I would think so. When it comes to research on humans, the guidelines are very strict. If the other group of women did not receive any clinical evaluation during the course of the 10 year trial period, it is ethically wrong.

How were they supposed to know if they developed a growth in their breast without knowledge on how to perform a BSE. I'm pretty sure the NCI researchers monitored the non-BSE group, carefully.

I just think the money could've been better spent elsewhere, than to focus on the reliability and validity on the BSE, which allows the woman to tell on her own, if she has a growth/lump in the breast area without a clinical evaluation/check-up.

[achtungbaby]

Thanks for posting this bun-boy.

[deez nuts]

Originally posted by achtungbaby@Oct 2 2002, 09:25 AM
Thanks for posting this bun-boy.

It's all good, chief.


I just find it slightly suspect that they ran the research on Chinese women, yes I know it was in conjunction with Chinese researchers. But, to deny teaching one group of women the BSE and the whole minority "guinea pig" factor disturbs me. Exposing one sample group of people to a lower probability of detecting any growth in the breast. No matter how miniscule or insignificant the BSE itself might seem, even with clinical evaluations is kinda lost and slightly disturbing to me. Am I being too sensitive?


But then again the saying goes the folks in research don't understand the folks in clinical, and the folks in clinical really don't understand the folks in research. But, it's a symbiotic relationship.



<!--EDIT|Chasiubao_Boy|Oct 2 2002, 09:37 AM-->

[SunWuKong]

Originally posted by Chasiubao_Boy@Oct 2 2002, 08:51 AM

I would think so. When it comes to research on humans, the guidelines are very strict. If the other group of women did not receive any clinical evaluation during the course of the 10 year trial period, it is ethically wrong.

How were they supposed to know if they developed a growth in their breast without knowledge on how to perform a BSE. I'm pretty sure the NCI researchers monitored the non-BSE group, carefully.

I just think the money could've been better spent elsewhere, than to focus on the reliability and validity on the BSE, which allows the woman to tell on her own, if she has a growth/lump in the breast area without a clinical evaluation/check-up.

but the problem i see with this study is that, well they had to have been monitoring the non-BSE group closely because the whole point is to find out how many of them develop breast cancer. so what did they do when they clinically discover benign lumps in those women? do they not treat those women?

i mean aren't they really just giving clinical exams to one group, and then telling the other group to do BSEs? if so of course they didn't see a difference! a better study would be to leave the non-BSE group alone for the entire 10 years and then go back to them at the end of 10 years to see how many of them developed breast cancer. (maybe that's what they did?)

[deez nuts]

Originally posted by SunWuKung@Oct 2 2002, 10:29 AM

but the problem i see with this study is that, well they had to have been monitoring the non-BSE group closely because the whole point is to find out how many of them develop breast cancer. so what did they do when they clinically discover benign lumps in those women? do they not treat those women?

i mean aren't they really just giving clinical exams to one group, and then telling the other group to do BSEs? if so of course they didn't see a difference! a better study would be to leave the non-BSE group alone for the entire 10 years and then go back to them at the end of 10 years to see how many of them developed breast cancer. (maybe that's what they did?)

The only problem is that there will be no way it would pass approval of the IRB, NIH, NCI or the ethics board. You're right it would indeed be more accurate, no question about it. But doing a longitudinal breast cancer study to involve two groups of human subjects and totally ignoring one of the two sample pools as a control group and not monitoring them might be a clinical disaster.

Yes one can argue, that if this study hasn't taken place, they would have gone on clueless on the BSE and might've gotten breast cancer anyways. But once you step in to do a longitudinal research project, you have a moral and ethical obligation to monitor and ensure the well being of your human subjects. There needs to be some sort of monitoring for the control group. That's just might point of view. I'm clinical, not research.

It was originally stated in the abstract (proposal for funding of the research project) that they did indeed intend to treat those that developed lumps in the breast.

[SunWuKong]

Originally posted by Chasiubao_Boy@Oct 2 2002, 11:01 AM

The only problem is that there will be no way it would pass approval of the IRB, NIH, NCI or the ethics board. You're right it would indeed be more accurate, no question about it. But doing a longitudinal breast cancer study to involve two groups of human subjects and totally ignoring one of the two sample pools as a control group and not monitoring them might be a clinical disaster.

Yes one can argue, that if this study hasn't taken place, they would have gone on clueless on the BSE and might've gotten breast cancer anyways. But once you step in to do a longitudinal research project, you have a moral and ethical obligation to monitor and ensure the well being of your human subjects. There needs to be some sort of monitoring for the control group. That's just might point of view. I'm clinical, not research.

It was originally stated in the abstract (proposal for funding of the research project) that they did indeed intend to treat those that developed lumps in the breast.

then see, i think that all they did was divide a group of women, and for one group gave them regularly scheduled clinical exams, while for the other group supervised them in regularly scheduled BSEs. of course one group is not going have a higher chance of developing breast cancer! i'm probably oversimplifying the entire study, but if what i think is basically true, i don't see how useful this study is at all.

that really annoys me, how some scientific research is just so fickle.



<!--EDIT|SunWuKung|Oct 2 2002, 11:34 AM-->

[deez nuts]

Originally posted by SunWuKung@Oct 2 2002, 11:32 AM

then see, i think that all they did was divide a group of women, and for one group gave them regularly scheduled clinical exams, while for the other group supervised them in regularly scheduled BSEs. of course one group is not going have a higher chance of developing breast cancer! i'm probably oversimplifying the entire study, but if what i think is basically true, i don't see how useful this study is at all.

that really annoys me, how some scientific research is just so fickle.

I am in complete and utter agreeance with you, that's what I was saying from the get-go.

Research is necessary. But in this particular case, the money would've been better spent on buying mammogram machines for some of the major Chinese hospitals/health clinics. I mean one of the statements of the NCI is "To prevent and treat cancers worldwide" the last time I checked. In my opinion of course.

[SunWuKong]

Originally posted by Chasiubao_Boy@Oct 2 2002, 11:40 AM

I am in complete and utter agreeance with you, that's what I was saying from the get-go.

Research is necessary. But in this particular case, the money would've been better spent on buying mammogram machines for some of the major Chinese hospitals/health clinics. I mean one of the statements of the NCI is "To prevent and treat cancers worldwide" the last time I checked. In my opinion of course.

fuck this is even starting to piss me off a bit because it was in shanghai.

[deez nuts]

Hahah bro, now you see why it was disturbing to me. The fact this took place in Shanghai and the study itself.