Breast Self-Examination Practices and Breast-Cancer Stage

To determine the relation between breast self-examination performance and the clinical and pathological stage of breast cancer at first diagnosis, we studied 335 patients with breast cancer. Approximately one fourth of the patients reported that they had been practicing monthly breast self-examination, and half that they had never practiced breast self-examination. More frequent performance of breast self-examination was associated with more favorable clinical stage and fewer axillary-lymph-node metastases on histologic examination. On pathological examination, the age-adjusted maximum tumor diameter of patients practicing monthly breast self-examination was 1.97±0.22 cm (mean ± S.E.M.) as compared to 2.47±0.20 for those performing selfexamination less often than monthly and 3.59±0.15 for patients never performing breast self-examination. These data associating more favorable clinical and pathological stages of breast cancer with more frequent breast self-examination need to be extended by determination of the survival rates of the various self-examination groups. (N Engl J Med 299:265–270, 1978) BREAST cancer is the single largest cause of death from cancer among women in the United States. In nearly one out of every 13 women in the United States breast cancer is expected to develop at some time in her life — approximately a 7 per cent chance.¹ Since treatment of smaller cancers generally leads to better cure rates than that of larger cancers, breast self-examination has been widely recommended. There are very few data, however, on the effect of self-examination on earlier detection of breast cancer. We analyzed the data collected in a statewide breast-cancer registry to determine the.