New Canadian guidelines nix breast self-examination

Controversial new guidelines have only confused women about how often they should have mammograms and whether they should perform breast self-examinations.

The Canadian Task Force on Preventive Health Care recently released new breast cancer screening guidelines that include these recommendations:

• women age 40 to 49 shouldn’t have mammograms
• women age 50 to 74 only need a mammogram every two to three years

The Task Force also recommends that women with a low breast cancer risk or no symptoms stop performing breast self-exams. And that their doctors should no longer perform breast exams.

Who the guidelines don’t apply to
These guidelines “do not apply to women at higher risk due to personal history of breast cancer, history of breast cancer in first degree relative, known BRCA1/BRCA2 mutation, or prior chest wall radiation.”

We all know women—mothers, sisters, relatives, friends, perhaps even ourselves—who discovered a lump in their breast early because they performed regular breast self-examinations. And not all of those women were predisposed to a risk of breast cancer.

We know our own bodies better than anyone else, and it seems intuitive that we should examine our breasts. But research studies have shown that women who don’t perform self-exams are no more likely to be diagnosed with, and die of, breast cancer than women who perform self-exams.

Nonetheless, the Canadian Cancer Society states that “whatever your age, you should know what is normal for your breasts.” Without performing regular monthly self-exams, this is not possible.

As health costs escalate, health care systems are under pressure to reduce costs. And the cynical may say that these guidelines ultimately reduce health care costs.

But will these guidelines provide low-risk women with a false sense of security about their breast cancer risk? Will breast cancer go undetected in low-risk individuals?

PEI and BC take a stand
Not all provinces are adopting the new guidelines. PEI has announced it won’t change its breast screening practices, and BC will carry on with usual screening procedures for six months until a provincial review is completed.

According to the Canadian Breast Cancer Foundation the breast cancer death rate has been reduced by more than 30 percent since 1986. Let’s hope these new guidelines won’t negate the advances made in the fight against breast cancer.

Breast cancer statistics

• women in their 40s make up 20 percent of cases
• women in their 50s make up 25 percent of cases
•  women in their 60s make up 27 percent of cases
• women over 70 make up 28 percent of cases

Did you discover a lump through a breast self-exam? What do you think of the new guidelines?