Breastcancer.org performed polling on more than 3,000 young women between 8 and 18 from Philadelphia, Atlanta, Baltimore, and Los Angeles, to determine fears of breast cancer among pre-mammogram-age women.
The survey found that 31% of these young women mistook a sign of normal breast development as a symptom of breast cancer - even though breast cancer in young women is exceedingly rare. The survey also indicated that 67% of these young women had a relative or close acquaintance with breast cancer.
In fact, this correlates to a change in women's health care that I have experienced: some medical practices now recommend that young patients cease self-examination for breast cancer, because of the false positives and ensuing fear.
Meanwhile, the National Breast Cancer Foundation maintains:
"Nearly 70% of all breast cancers are found through self-exams and with early detection the 5-year survival rate is 98%. If you find a lump, schedule an appointment with your doctor, but don't panic--8 out of 10 lumps are not cancerous. For additional peace of mind, call your doctor whenever you have concerns."
The exception appears to apply to young women. Have you had any experience with this change of message?
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From my understanding, providers are shying away from necessarily encouraging a formal self breast exam. My provider discussed this with me letting me know that a lot of young women perform SBE's incorrectly and therefore ineffectively and that it would actually be better for women to just be familiar with their breasts and touch them in a way that makes them feel comfortable and that then they will be more likely to notice changes. I know for myself at 22 with fibrocystic breasts, when I do a formal SBE all I feel is lumps. However when just casually feeling my own breasts, I am much more likely to be able to note specific changes. But that may just be me =)
From my understanding, providers are shying away from necessarily encouraging a formal self breast exam. My provider discussed this with me letting me know that a lot of young women perform SBE's incorrectly and therefore ineffectively and that it would actually be better for women to just be familiar with their breasts and touch them in a way that makes them feel comfortable and that then they will be more likely to notice changes. I know for myself at 22 with fibrocystic breasts, when I do a formal SBE all I feel is lumps. However when just casually feeling my own breasts, I am much more likely to be able to note specific changes. But that may just be me =)
I read once the purpose of the self-examine for young women and girls was for them to get used to what their breast tissue feels like, so when women reach the age when breast cancer becomes more likely, they will know what is normal for their breasts and be able to detect abnormal lumps. Of course, abstinence-only sex education fails to address that (or at least mine did). I think we will have an entire generation of women ignorant about their bodies if we do not teach them now. In my opinion, not recommending young girls before self-examines is just another step in the wrong direction. Girls need to be told how, when, and WHY they need self-examines now.
I've always been encouraged to do the exams Now, I was also advised that I shouldn't start checking until my early 20's, because breasts change so much in the late teens and because the earliest of breast cancers don't show up until mid-late 20's early 30's. ,
But I do think I have an idea of why the false positives. We're told over and over and over again to check our breasts (and usually some advice as to how), but we're never really told what we're looking for; what is normal and what isn't. The texture of healthy breasts isn't really discussed. Effective self-exams need to be taught in-person with one's doctor, who can help you differentiate what's normal *for your breast* and what isn't. It can't be taught in a packet because healthy breasts come in a variety of textures. Instead we're just being told "Do this so you don't DIE of CANCER" without the how, so we have to fill in the blanks, and an afraid mind fills it in with paranoia.
I totally agree....when my doctor had me do self-exams/get used to your breasts when I was teen, I was just so confused as to what was normal and what wasn't, it just seemed useless to me so I stopped doing them.
This is pretty much what happened to me. When I was entering high school, I developed a lump on my breast that developed suddenly and painfully. That in itself should have indicated that the lump was non-cancerous, but the only thing I knew at that time was breast lump = cancer. So for too long of a time I was scared and depressed because I thought I had cancer. Thankfully, I'm over and done with it now, and know a lot more than I did back then. However, if I had known information about non-cancerous lumps before my lump incident, it would have saved me a lot of grief.
Yes, I had a very similar experience around 13, back when I was an AAA. Thankfully my mother is a nurse and was able to explain to me that breasts develop little painful lumps as they develop. Many girls are not so lucky.
This is such a complicated issue. We want young women to be aware of their bodies and any changes, and we want doctors to take them seriously. There are many young women who had symptoms but doctors said "you are too young" and didn't take them seriously. On the other hand, the chance of a lump actually being cancer in a young woman IS rare. So it's kind of a fine balance. What I would like to see is more work on the cause of breast cancer so that we can prevent these cancers from even occurring.
I also notice that some doctors want you to check daily, while others believe that you're more likely to notice a change if you do it, say, once a week. I always wonder about the relative merits, but I also struggle with remembering to floss my teeth daily.
And I agree that it would be *extremely* helpful if women were told what to look for.
My doctor was great about this--she told me that my breasts tended to be cystic and showed me what those felt like (she touched them, then had me touch them too). She then told me changes I'd be looking for would feel like little BBs or something like that, and that I should do it once a month, preferably not during my period.
I think women should be guided through the exams, and told what to look for as well...and when one is married or with a long term partner (who hopefully knows her body well), they should also be told what to look for, I think. Especially if they do their own "breast exams" often. :-)
Breast cancer is uncommon in young women who don't have the genetic abnormality that is associated with it.
My maternal grandma died of breast cancer, as did 2 of her sisters. My mom has terminal breast cancer, and so they tested her for the gene, which she has. If you have the gene you have about an 80% chance of getting breast cancer (among increases in other types of cancers). So my little sister, who has the gene, could very well get cancer before she's 30 and needs to do a ton of preventive stuff (including self exams). I don't have the gene, so I have normal population odds, meaning I don't have to do all the crazy extra stuff she has to do.
It looks to me like the biggest problem is when people think that a breast lump equals cancer, when it might mean cancer, a cyst, or a normal change in breast tissue over a woman's cycle. I think it would be a good idea to change the focus from "do BSEs so you notice breast cancer" to "do BSEs so you know what your breast tissue normally is like," with more of a focus on educating women about all types of breast changes/abnormalities from period symptoms to swollen milk ducts to cysts to tumors.
That being said, I always found it very difficult to allow another person to touch my breasts, boyfriends and doctors included. So it would likely be difficult for me to take the approach that another commenter did--examining yourself with a medical provider.
The move away from recommending self-exams came after a huge study published in 2002 did not find a difference in breast cancer-related mortality between a large group of women who were instructed to perform self-exams and a control group who did not perform self-exams. As self-exams have not been shown to reduce deaths, and could result in anxiety and unnecessary Mammograms and biopsies, many physicians are no longer recommending them to their patients.
I haven't really noticed a change in message. My gyno and my mom, who is an RN specialized in Oncology, both advise me to do a self exam every month.
I'm 21 and was recently diagnosed with having Fibrocystic Breasts, which is a condition where cysts form around the time of ovulation and then shrink back down after menstruation. With a history of breast cancer in the family and now having fibrocystic breasts, the only way I can notice any significant changes is if I check them twice a month. Once during ovulation and again post-menstruation to compare.
I agree with beth, the issue is education. It's important for women to know about all the possible breast abnormalities and not to immediately assume cancer. Telling young women to not check themselves and to only rely on a yearly check-up doesn't seem right. A lot can happen in a year and it's important to know what's up with your breasts.
i think it's worth pointing out that it's not just because of "ensuing fear," as you said, but also because it can lead to unnecessary procedures--all of which carry some amount of harm.
this is sort of similar to the prostate-specific antigen blood test done in older men. a lot of physicians are no longer doing it routinely, as it's likely to lead to a lot of biopsies and surgery in cases that are either non-cancerous or so slowly progressing that they never would have caused any problems.