Which of the following is true regarding breast cancer screening?
A) Teaching breast self-examination reduces breast cancer mortality.
B) Teaching breast self-examination should start at as early as 15 years of age.
C) The goal of the breast self-examination is to detect breast cancer.
D) Mammography is the only screening test shown to reduce breast cancer–related mortality.
Answer and Discussion
The answer is D.
Teaching self breast examination (SBE) does not reduce breast cancer mortality and may increase false-positive rates. Two large randomized international trials did not demonstrate a mortality benefit from teaching SBE. A review of eight other studies did not show a benefit from SBE in the rate of breast cancer diagnosis, tumor stage, or the rate of breast cancer. However, the number of times that women find lumps that lead to a breast cancer diagnosis warrants educating patients to recognize and report changes in their breasts. Thus, although there are no studies to support breast self-awareness, some organizations recommend encouraging women 20 years and older to recognize the normal feel of their breasts (rather than teaching formal SBE), and to report any changes to their physician.
Screening mammography has been shown to reduce breast cancer mortality. A meta-analysis found a 26% reduction in the relative risk of breast cancer–related mortality when women 50 to 74 years of age received screening mammography. Although there is general agreement that screening
mammography should be offered routinely to women 50 to 74 years of age, there are conflicting guidelines for its use in younger women.
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