WATERLOO- For years, women have been taught that their first weapon of defense in the war on breast cancer is a breast self-exam. However, new research indicates that women's biggest weapon of prevention may be a dud.

A recent study released by the Cochrane Collaboration, an international group that evaluates medical research, says there is no solid evidence that self-examinations have any impact on death rates among breast cancer patients, and may even increase stress and anxiety in women who regularly perform the exams.

"It goes back and forth just like everything in breast health," said Lisa Walker, mammography supervisor at Covenant Medical Center. "I think different groups study different things. Same thing with mammograms and hormone replacement therapy."

The study further concludes that many self-exams lead to unnecessary biopsies because the woman and her doctor don't want to ignore a lump that turns out to be harmless. It adds that doctors perform the test to help ease the woman's mind, but that some women report higher anxiety levels and loss of sleep even after getting a confirmed benign diagnosis.

Dr. Neil McMahon, a surgeon at Covenant, thinks the new study's message to women is ambiguous.

"They said that while regular BSE's were not necessary, they tell women to report any changes in their breasts to their doctors," McMahon said. "How else would you do that than with BSE?"

As for the idea that BSE leads to an increase in unnecessary biopsies, McMahon said that even with all the new technology available 10 percent of cancer is still missed.

"We rely heavily on BSE for women to pick up by feel what the test couldn't see," McMahon said.

Mary Seitz is a nurse at Covenant and a breast cancer survivor. Her cancer was discovered through a routine mammogram, but Seitz said she regularly performs BSE.

"I think it's very important to do," Seitz said. "In my case I was familiar with my breasts and knew they were normally dense, and I would have known if they changed. That would have been especially important if my mammogram didn't show anything. I think women need to be familiar with what is normal for their body so they can tell their doctor as soon as they notice something unusual."

Walker added that what is normal for some women will not be normal for others.

"Women need to be aware of anything that is not normal for them," Walker said. "Any tightening, swelling or dimpling of the skin. Things that you wouldn't normally feel need to be reported right away."

McMahon said that 35 percent of breast cancer is diagnosed by breast self-exams.

"That's a real important number if we're telling people not to do BSE," McMahon said. "Breast cancer mortality continues to drop in this country and we don't know why. We don't know if self-education plays a role or if better self-instruction is the cause. I would only emphasize the importance of breast awareness, and the only way to do that is with BSE."

Contact Samantha Donisi

at (319) 291-1423 or

samantha.donisi@wcfcourier.com.