ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Tuesday, March 11, 1997 TAG: 9703110136
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: HEALTH NOTES
SOURCE: SANDRA BROWN KELLY
After the news that came out last week, women might feel a little betrayed by the breast cancer experts and a whole lot fed up with the slowness in making progress against this disease.
Last week, a report in the Journal of the National Cancer Institute said that a Chinese study confirms, at least in a preliminary assessment, that breast self-examination does little to lower the number of deaths from breast cancer.
The experts, including the American Cancer Society, said women should depend more upon mammograms than self-examination, or rather, use the two in combo.
But, then, mammograms haven't made much of a dent in the deaths from breast cancer either.
So back to square one. Here we are, each month dreading that annual self-exam. Fearing that we will find a lump. Fearing that it will be cancer. Feeling like a failure if we don't do the exam.
A `prudent health practice'
Examine your breasts, the American Cancer Society consistently warns.
Now, Robert Smith, epidemiologist in the cancer control department at the American Cancer Society, says breast self-examination is merely a "prudent health practice." Teaching a woman to examine her breasts helps her know what her breasts feel like so if she notices a change, she will see a doctor.
How's that again?
"Breast self-examination's value is not so much as a screening technique, but as a means of raising awareness of changes that could be abnormal in the breast," said Dr. David B. Thomas, of the Fred Hutchinson Cancer Research Center in Seattle.
Thomas was first author of a study involving 267,000 Chinese textile workers who were divided into two groups - one group given extensive training in breast self-examination, the other given no training in it. The women had been born in the period from 1925 to 1958.
The study concluded that the group dedicated to breast self-examination did not find any more cancers at an earlier stage or smaller size than the women who weren't devoted to self-examination.
In other words, it didn't make any difference if they examined themselves or not. About the same number in both groups were diagnosed with breast cancer. The examiners did find more benign breast tumors, however.
Conclusions from the study, conducted 1989-1994:
Breast self-examination has not led to a reduction in mortality from breast cancer in this study in the first several years since it began.
Breast self-examination does not lead to an earlier diagnosis of the disease.
Longer follow-up of participants is required before final assessment can be made of the efficacy of breast self-examination.
The real conclusion?
Women, men too, need to know their bodies so when something appears to change they can bring it to the attention of a doctor. That goes for lumps under the arm, behind the knee, in the groin, in the calf of the leg or just anything that's different about the body.
But, don't be lulled that by diligently knowing your body, you will make a great difference in the end.
Frustrating, yes, very.
"Continuing justification of the skepticism some people have of modern medicine!" is how one of my colleagues assessed it.
Reminders
Adult CPR (cardiopulmonary resuscitation) training certification will be offered for $10 at special sessions Saturday from 8 a.m. to noon or 1 to 5 p.m. at the Roanoke Valley Chapter of the American Red Cross, 325 Church Ave. Registration is required by Wednesday; call 985-3550. If you live closer to Lynchburg, you can learn CPR on Saturday during a 8 a.m.-noon course at Lynchburg General Hospital. Call 804-846-6559 for information on this.
A free health lecture on how to lower risks of osteoporosis and an open house are planned March 19, 7-8:30 p.m. at the Salem Lewis-Gale Clinic's Department of Arthritis and Rheumatology. Some participants will receive a free bone density test.
The Blue Ridge Chapter, National Multiple Sclerosis Society, is holding a conference for health professionals March 22 at the Lynchburg Hilton. Dr. Lauren Krupp, co-director of the Comprehensive MS Care Center at Stony Brook, New York, will discuss new directions in the management of the disease. She is the co-principal investigator in three drug trials for people with MS.
The program also is open to the general public. For more information, call (800) 451-0373. The society's e-mail address is infoxc2nmss.org. Its website is http://www.nmss.org.
You can reach Sandra Brown Kelly at (800) 346-1234, x393; 981-3393, or sandrak@roanoke.com.
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