The Latest on the BSE Controversy


© Linda Bily

For several years, a passionate debate has gone on about the value of mammography and breast self-exam (BSE). The national breast cancer organizations, for the most part, have always stressed the importance of BSE and mammography to the public. Part of the community outreach programs have included BSE shower cards and I personally have always advocated for monthly BSE and annual mammograms for women over 40, as a general rule.

Recently, several new studies have come out that state that BSE does not save lives. I do not believe that anyone has ever claimed that BSE saves lives. The theory behind self-exam is to get to know YOUR breasts, so that you can detect any changes which occur (whether benign, malignant or just different.

Many of the organizations who promote education and awareness about breast cancer are still advocating self-exam, as am I. It's good for you to be aware of what is going on in your body. Even if BSE will not "save" your life, early detection is the KEY to breast cancer treatment. The earlier the cancer is found, the greater chance that it can be caught at an early stage and treated successfully.

Of course, there will be some exceptions - some women who are diagnosed at Stage 1, or even with DCIS (Stage 0 or pre-cancerous cells, depending on who you talk to), will still progress to Stage IV, or have a virulent, aggressive form of cancer which will not respond well. In general, however, the earlier the cancer is caught, the better the chance for success.

Statistically, 70-90% of women with Stage I cancer will be alive in 5 years. There, unfortunately, have to be some people who are in the other 10%. The reverse side of the coin is that if there are only 5% who will be alive in 5 years with Stage IV breast cancer, someone does have to be in the lucky 5%.

There are statements that BSE can cause harm, mainly beause those who have taken the opposite view fear that women will be running to the breast specialist with either lump and bump and that ultimately, needless biopsies will be performed. While this may be the case once in a while, I have confidence that most of the medical profession will not suggest a biopsy on a whim. I also hope that women have become better educated about their choices and will never just do something medically because "the doctor said so."

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