Susan Love: The breast self-exam is wishful thinking. We wish the self-exam worked in terms of early detection but it really doesn't work very well, and it distracts us from moving forward to find something that really does work.
Terry Gross:Why doesn't it work?
Love: Because the notion of early detection isn't entirely right. We've sold it as if every cancer goes from a grain of sand to a BB to a pea to a grape to a lemon to a grapefruit, and if you just do your breast self-exam you can find the grain of sand and life will be great.
The problem is that what you're feeling when you feel a cancer is not the cancer cells; it's the reaction those cells incite around them. In some people the cancer shows up as a grape, in others as a grapefruit. And this notion that if you just examined yourself you would find it at a smaller size isn't true. Some people are lucky and they do have lumps that are found really early. But not everybody.
Gross:How are most lumps discovered?
Love: Most women find their own lumps, but they don't find them doing breast self-exams. They find it in the shower. Or they're rolling over in bed, or their lover finds it. It's not because they stood in front of the mirror and did a whole song and dance. Most women in fact don't do self-exams; they're too scared.
Most importantly, I think the hype about self-exams alienates women from their bodies. Instead of thinking of your breast as a nice friendly part of you, it becomes the enemy, and your job is to find the hidden land mine that's going to do you in.
Breast self-exam was invented at a time when women really didn't touch themselves 'down there,' which meant below the chin. Nowadays many more women are more aware and they are [familiar with their bodies]. But they feel they need to catalog every grain of sand and go on a search-and-destroy mission. That isn't necessary.
Gross:Do you think I'm going to get a lot of phone calls from gynecologists saying that what you have just said is irresponsible?
Love: No. It's not evil for people to be doing breast self-exams. I just think we shouldn't be putting so much money into promoting it. We should be putting the money into finding a really good way of early detection. Maybe a blood test.
Reprinted with permission of Fresh Air/WHYY, Philadelphia, PA 19106.