cc:
Subject: [Fwd: FW: Canadian Breast Cancer Network Media
Release June 26, 2001]
Here is the Canadian Breast Cancer Network's media release in response to
the study Should women be routinely taught breast self-examination to screen
for breast cancer? published today in the Canadian Medical Association
Journal and the subject of front page headlines and radio and TV news
reports across the nation.
CBCN's media release can also be found on our website (
<http://www.cbcn.ca/> www.cbcn.ca), along with news releases from the
Canadian Breast Cancer Foundation and the Breast Cancer Support Services
Inc.
The article Should women be routinely taught breast self-examination to
screen for breast cancer? and a commentary can be found at the following
url:
http://www.cma.ca/cmaj/vol-164/issue-13/issue-13.htm
<http://www.cma.ca/cmaj/vol-164/issue-13/issue-13.htm>
We invite you to send news releases or statements from your groups as well
as personal testimonials from breast cancer survivors (who may remain
anonymous if they wish) for posting on our website. Send information to
Jackie Manthorne, Executive Director, at [log in to unmask]
Canadian Breast Cancer Network
R?seau canadien du cancer du sein
331 rue Cooper Street, Suite 602, Ottawa, ON K2P 0G5
Tel: (613) 230-3044 Fax: (613) 230-4424 1-800-685-8820
[log in to unmask]; <http://www.cbcn.ca/> http://www.cbcn.ca
Media Release
For immediate release, June 26, 2001
The Canadian Breast Cancer Network (CBCN) views the statements by Dr. Nancy
Baxter, author of the paper "Preventive health care, 2001 update: Should
women be routinely taught breast self-examination to screen for breast
cancer?" released today in the Canadian Medical Association Journal, with
skepticism, caution and alarm.
The study contradicts over thirty years of evidence regarding the value of
breast self-exam (BSE) by women for the early detection of breast cancer.
Firstly, CBCN is concerned about the participants in the trials, as well as
the time frame for the statistics. Both the Russian and Chinese studies
involved women who used BSE as their only method for detection of breast
cancer, while most North American women utilize self-exam as well as
mammography. Also, five years is not sufficient to accurately assess
mortality data.
If younger women and women in the 40 - 50 age group, who are not part of
most breast screening programs, are told that breast self-examination is of
no use, they are in a much more vulnerable position. Added to this, to be
told that BSE may actually cause harm is totally wrong. Most women,
particularly those who have had breast cancer, would probably undergo a
biopsy in order to catch a new cancer or a recurrence, even if it proved
negative. It appears that there is more concern about the cost of
unnecessary biopsies than in detecting breast cancer early. If a woman finds
a lump, and lives with knowing it is there for a year or more, that anxiety
is much greater than having a biopsy and putting the issue to rest.
The message of the study appears to be that women have no control over or
knowledge of their own bodies. This is a fallacy. Women know their breasts
far better than their family physicians. Without BSE, younger women are
being advised to put all their faith in a GP's annual exam of their breasts
during a physical. Considering that most family doctors only receive about
two hours training in how to give a proper clinical breast exam in four
years of medical school, do women want to place their lives in a GP's hands?
Another issue to be considered is: how many women, particularly young
healthy women, have an annual physical?
This study also implies that women should put implicit faith in mammography
alone. Most screening programs in Canada only screen women from the ages of
50 to 69 years of age, with the exception of British Columbia, which screens
to 74. Currently, women receiving mammography through screening programs in
Ontario, Manitoba, Nova Scotia, PEI and Newfoundland are given a clinical
breast examination by a trained health care professional. Will this
component now be dropped from the screening programs? Younger women are not
encouraged to have annual mammograms unless they are at high risk, or carry
one of the breast cancer genes. Even at best, mammography is not infallible
and does not pick up all breast cancers, even some of the larger tumours due
to high breast density in younger women. These women often have faster
growing tumours than older women, which can be missed even with annual
screening. I was a perfect case in point. Having begun mammography annually
at age 40 because my mother died of breast cancer, I found a
three-centimeter lump just after my mammogram at age 48. Last year, I found
another tiny lump just above my lumpectomy scar. The oncologist thought that
it was scar tissue and reassured me. The mammogram showed nothing. If I had
not been proactive and insisted upon a biopsy, that carcinoma would have had
another year to grow before it was checked again.
Although the goal of the screening programs across Canada is to have women
aged 50-69 screened every second year along with a clinical breast exam by a
nurse practitioner, they are far from reaching their 70% target audience. In
1997 and 1998, data showed that participation of the target group ranged
from 11.5% to 54.7% across Canada, which is well below their goal.
CBCN urges women who are currently practicing breast self-exam to continue
to perform it monthly, despite the CMAJ article. Women should always have a
choice. If a woman chooses not to do BSE and puts her faith in an annual
physical, including a clinical breast exam, and/or in mammography, then that
is her choice, and she should not feel guilty. However, considering the fact
the women age 40-50 are not currently included in the screening programs, we
encourage these women to learn to do BSE and practice it regularly. It is
all about being pro-active about your own personal health!
Karen DeKoning
President
Canadian Breast Cancer Network
For further information or to interview Ms. DeKoning, please contact the
Canadian Breast Cancer Network, 1-800-685-8820.
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