Early diagnosis of breast cancer: the breast self-examination problem.

Only ten percent of 1000 consecutive patients attending the St. Michael's Hospital Breast Clinic were practicing breast self-examination regularly. Seventy percent had tried and quit because of confusion, frustration and terror over what they had felt in their breasts. They were encouraged to start again and learn what 'normal' felt like on the night of the clinical examination, after each woman had been reassured that her breasts were 'normal for her'.Of 533 women who have attended subsequently for annual re-examination, 75 percent are practicing breast self-examination regularly, confident that they know what 'normal' feels like and reasonably confident that they can detect any change from normal in the future.Women should be advised not to start breast self-examination until they have had a clinical examination by their doctor. Thereupon they should start immediately to learn 'what normal feels like' and thus provide a reasonable baseline for monthly re-examination.The number of doctors' clinical examinations so stimulated will yield extra dividends in the discovery of unsuspected lumps in the breast.