Why Self-Exams Don't Work

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Dr. Susan Love directs the Revlon/UCLA Breast Center and co-founded the National Breast Cancer Coalition. When she became a surgeon in 1980 there were almost no women surgeons working with breast cancer patients. In the new edition of her groundbreaking work, Dr. Susan Love's Breast Book (Addison-Wesley, 1995), she questions the importance of breast self-exams. National Public Radio's Terry Gross recently asked her to elaborate.

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.