Doctor cautions women to regulate self-exams

Women who regularly examine their breasts in a bid to beat cancer risk damaging their health, according to a leading medical expert.

Professor Michael Baum, who set up one of Britain's first cancer screening centres, warned that breast self-examination (BSE) can lead to unnecessary surgery and false diagnoses and does not give women a better chance of surviving the disease.

His views contradict the advice of doctors who have encouraged women to catch cancer early by checking their breasts for abnormal lumps. Their advice is based on the belief that it is better to remove a tumour early when it is small.

Professor Baum, who is emeritus professor of surgery at University College London, argues in a guide published this month that this approach is too simplistic because not all breast cancers are the same. He believes it can lead to futile biopsies.

Professor Baum is also critical of the amount of money spent on screening women for breast cancer, arguing that overuse of the service can result in unnecessary invasive treatment and over-diagnosis of cancers which are not life-threatening.

He said: "There is an intuitive belief that regular breast self-examination will prevent women dying of cancer. [But] BSE is bad for you. It is a futile exercise. The answer is to concentrate on more research and better treatment."

Breast cancer is the most common cancer affecting women from all backgrounds. Doctors diagnose more than 40,000 cases every year, a figure which has risen partly as a result of changes in lifestyle such as excessive drinking, a rise in obesity and the trend for women to have children later in life.

The majority of patients are women aged 50 and over, although younger women may also be affected.

Last week, it was revealed that Kylie Minogue, the chart-topping singer, has breast cancer. She had an operation on Friday. Her surgeon Dr Jenny Senior said the operation was a success.

In his new guide, which is intended for junior doctors and nursing specialists, Professor Baum says that women should become more "breast aware" instead of obsessively checking for lumps.

His advice is that they should learn to distinguish between normal and abnormal changes in their breasts.

This includes looking out for any unusual pain, nipple discharge and dimpling of the skin, as well as lumps if they are new and not related to their menstrual cycle.

The fight against breast cancer has received huge support from celebrities. But Liz Carroll, from Breast Cancer Care, said that sometimes using celebrities instead of trained experts to back campaigns has led to women receiving confused messages.

Ms Carroll, head of clinical services at the charity said: "They [celebrities] are not medical professionals. Women hear one thing and then another. It's not about doing a ritual breast examination once a month but knowing their own breasts when they are showering or putting on cream, getting to know what is normal for them."

However, she said that checking for lumps may reduce the amount of treatment that a woman will need.

"If you find something early it may mean less surgery or no intensive chemotherapy," Ms Carroll added.

Although increasing numbers of women are getting breast cancer, the death rates have fallen by a fifth in the past 10 years, a drop which has been attributed to improvements in treatment, especially new drugs.

Breast exams

* Recent clinical trials have suggested that there is no difference in breast cancer mortality rates between women who do and those who do not examine their breasts.
* In fact these studies have shown that women who practise breast self-examination (BSE) have twice as many false alarms and unnecessary surgery as those who do not self-examine.

- INDEPENDENT