Avis Antel

In September, the Canadian Cancer Society announced that it no longer recommends routine breast self-examination (BSE) to detect breast cancer. This decision was at least partly based on an important report written by Dr. Nancy Baxter, assistant professor at the University of Toronto (CMAJ. 2001 June 26; 164(13): 1837–1846) ; this report suggested that BSE does not improve breast cancer outcome due to errors in self-reporting and the unnecessary biopsies that may follow.

Although regular BSE may no longer be recommended, Heather Chappell of the CCS encourages women to be familiar with their breasts so they know what is normal for them. In other words, while it’s important for women to look and feel for any changes in their breasts, they don’t need to follow a particular technique or schedule. Many women have found their own cancers, and being aware of what is normal for them is an important part of this.

The Canadian Cancer Society also reaffirmed the importance of mammography as a method of screening for breast cancer and now recommends that:

Women between the ages of 50 to 69 have a mammogram every two years.

Women between the ages of 40 and 49 discuss their risk of breast cancer and the benefits and risks of mammography with their doctors.

Women over the age of 40 have a clinical breast examination by a trained health professional every two years at a minimum.

Women get to know their breasts and discuss any changes with their doctors.

In the Fall 2001 BCAM Bulletin, in a response to the Baxter report, we said, “We believe that all options should be available to women. Furthermore, we believe that clinical breast exams should be part of the provincial screening program in Quebec. ” We reiterate that position.