PURPOSE OF REVIEW: Breast Self-Examination (BSE) remains controversial despite the 2009 United States Preventive Service Task Force (USPSTF) recommendation against teaching of BSE. The USPSTF recommendations were based on results from the Shanghai Study, high-quality randomized trial of BSE in 266,064 Chinese factory workers from 1989-1991; women instructed in BSE did not have a significant difference in mortality versus uninstructed controls. Regardless of the outcome of the Shanghai Study, the practice of BSE in the United States (U.S.) over the past 25 years has been associated with a marked reduction in the size of breast cancer identified by women. RECENT FINDINGS: In the Shanghai study, BSE was tested in China from 1989-1991. During this time period, Chinese breast cancer screening and treatment was not consistent with standard-of-care in U.S. and Europe. Breast cancer was a rare illness in China in the 1980's. Treatment was not standardized; there was no breast imaging or margin assessment of the tumor. Tumor markers (e.g. estrogen receptor, progesterone receptor) were not reported. The Shanghai Study did not report in detail on the anti-cancer agents provided to women who enrolled in the trial. SUMMARY: BSE needs to be rigorously re-evaluated under current standard of care.
PURPOSE OF REVIEW: Breast Self-Examination (BSE) remains controversial despite the 2009 United States Preventive Service Task Force (USPSTF) recommendation against teaching of BSE. The USPSTF recommendations were based on results from the Shanghai Study, high-quality randomized trial of BSE in 266,064 Chinese factory workers from 1989-1991; women instructed in BSE did not have a significant difference in mortality versus uninstructed controls. Regardless of the outcome of the Shanghai Study, the practice of BSE in the United States (U.S.) over the past 25 years has been associated with a marked reduction in the size of breast cancer identified by women. RECENT FINDINGS: In the Shanghai study, BSE was tested in China from 1989-1991. During this time period, Chinese breast cancer screening and treatment was not consistent with standard-of-care in U.S. and Europe. Breast cancer was a rare illness in China in the 1980's. Treatment was not standardized; there was no breast imaging or margin assessment of the tumor. Tumor markers (e.g. estrogen receptor, progesterone receptor) were not reported. The Shanghai Study did not report in detail on the anti-cancer agents provided to women who enrolled in the trial. SUMMARY: BSE needs to be rigorously re-evaluated under current standard of care.
Entities:
Keywords:
breast cancer screening; breast self-examination; early detection
Authors: David B Thomas; Dao Li Gao; Roberta M Ray; Wen Wan Wang; Charlene J Allison; Fan Liang Chen; Peggy Porter; Yong Wei Hu; Guan Lin Zhao; Lei Da Pan; Wenjin Li; Chunyuan Wu; Zakia Coriaty; Ilonka Evans; Ming Gang Lin; Helge Stalsberg; Steven G Self Journal: J Natl Cancer Inst Date: 2002-10-02 Impact factor: 13.506