
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, February 21, 1991                   TAG: 9102210449
SECTION: NATL/INTL                    PAGE: C-6   EDITION: EVENING 
SOURCE: Newsday
DATELINE:                                 LENGTH: Medium

BREAST EXAMS' VALUE CALLED INTO QUESTION

Breast self-examination has little or no benefit as a screening tool to detect cancer because most women do not do it or perform it incorrectly, according to a study.

The study, conducted in the Seattle area and to be published in the Journal of the National Cancer Institute, found that when done properly, the practice was equivalent to decreasing the risk of developing advanced-stage breast cancer by one-third. But researchers reported that only 8 percent of the women did the examination correctly.

Still, cancer experts defended the use of examinations to find some cancers early on.

"Most women are not trained to be physicians, said Polly A. Newcomb, the study's lead author and an epidemiologist at the University of Wisconsin. To do a thorough exam, you need objectivity. You have to do it systematically. Most women don't."

Newcomb conducted the survey among 209 women with advanced breast cancer in a single medical group practice. But they were representative of women from a large city area, she said.

In fact, Newcomb's study of a control group of 433 healthy women from the general Seattle population had roughly the same results.

A recent British study found breast cancer mortality after six years was virtually the same among 64,000 women offered instruction in breast self-examinations and 127,000 who were not.

The studies were undertaken because the public health policy benefits of breast self-examination have yet to be shown, doctors say. Some experts argue that more emphasis should be placed on making mammography more available because it is the only proven way to catch breast cancers early enough so that treatment is effective.

The American Cancer Society recommends that women over 20 examine their breasts monthly. For women over 40 the society recommends self-examination be supplemented by annual doctor's exams and by mammograms every one or two years.

The Seattle study interviewed 209 women with advanced-stage breast cancer (those whose cancer had spread) and scored them according to their use of up to 10 recommended techniques.

Only 8 percent did self-exams with high proficiency - meaning they used at least four of the 10 techniques, the study said. Seventy-six percent either said they did not do self-exams or were scored as performing it poorly. Only 41 percent said did self-examinations monthly or more frequently.

by CNB