As I often do when preparing to write a monthly newsletter article, I consult the list of National Health Observances published annually by the US Department of Health and Human Services. At the top of the list for October each year is Breast Cancer Awareness. In addition, this year, there are two other days, Metastatic Breast Cancer Awareness Day, October 13, and National Mammogram Day, October 18. The health concern of course that has dominated all lists for the past year and one-half is Covid-19. The effects of Covid -19 on individual personal health care may be far more reaching that can been seen at first glance. Emerging evidence tells us that health threats from postponing routine yearly tests and exams outweigh the risk of running into the coronavirus at the doctor’s visit. One survey showed that the total number of cancer screening tests received by women through the National Breast and Cervical Cancer Early Detection Program declined by 87 percent for breast cancer during April 2020 as compared with the previous 5-year averages for that month.
One concern that I have had for a number of years regarding screening is the October, 2015 recommendation by the American Cancer Society that breast-self exam (BSE) or physician breast exam is no longer necessary. The explanation that I found at that time states: “Breast exams are no longer a part of the screening recommendations because research does not show they provide a clear benefit.” However, the American Cancer Society says all women should be familiar with how their breasts normally look and feel and report any changes to their health care provider right away.
As a wellness/health promotion advocate, I continued to ponder the question of breast self-exam guidelines. I found a July 2008 media advisory written by Dr. Marisa Weiss, President and founder of breastcancer.org responding to “new” guidelines about breast self-exam. Could it actually have been 2008 that we first heard that it was recommended that we no longer needed to do breast self-exams. The 2008 guidelines first released in Denmark and supported by a review of breast self-exam studies conducted in Russia and China suggested that this practice did not reduce deaths from cancer and could not be recommended. Dr Weiss stated that the “new guidelines could seriously endanger women’s health and lead to late detection of cancers in some women.” At that time 20 percent of breast cancers were found by physical exam, not mammography. Even at this percentage, breast self-exam certainly seems to be a significant tool given the fact that early detection even with mammography is imperfect. In addition, “The new guidelines send the wrong message to women about their role in their own health care, especially when so many women cannot afford doctor visits and medical testing.”
Today you do not routinely see the message of breast self-exam as part of the message of early detection of breast cancer. With current statistics showing that one in every eight women will develop breast cancer in their lifetime it is time that women empower themselves by taking proactive steps in examining themselves monthly to detect even the smallest changes in breast tissue. breastcancer.org still believes that breast self-examination is a useful and important screening tool, especially when used in combination with regular yearly physical exams, mammography, and in some cases ultrasound and/or MRI. Each of these screening tools works in a different way and has strengths and weaknesses. As many individuals may have delayed routine screenings during the pandemic, those same individuals may have never been taught the importance of doing breast self-exam. Breast self-exam is easy, takes a few minutes once a month and could potentially save your life. If you have teenage daughters, empower them with this knowledge and help them to understand the importance of this small monthly investment in their own health. Be your own health advocate with a monthly breast self-exam knowing that you are empowering yourself and your personal health! Empower yourself further and schedule those health exams that you might have missed during the due to Covid-19.
Remember, it is time for your annual flu vaccine!
- Breast Self-Exam, How to do a Breast Self-Exam: The Five Steps, breastcancer.org.
- CDC Newsroom, Sharp Declines in Breast and Cervical Cancer Screening, Centers for Disease Control and Prevention, June 30, 2021, cdc.gov.
- National Health Observances, U. S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Breast Cancer Awareness Month, health.gov.
- Kendrick, MD., Kristen, 5 Medical Appointments You Should Stop Putting Off, Nashville Public Radio, WPLN News, 90.3, March 2, 2021.
- Simon, Stacy, Senior Editor, News, American Cancer Society Releases New Breast Cancer Guideline, October 20, 2015, cancer.org.
- Weiss, Marisa, MD, July 15, 2008: New Guidelines Against Breast Self-Examination Could Seriously Endanger Women’s Health, breastcancer.org.
Cornelia Pearson, RN, MN
Member, St. Andrew Lutheran Church