Like a lot of U.S. women now, I'm confused about the recent recommendations from the Preventive Services Task Force of the Department of Health and Human Services -- especially their advice on breast self-exams.
I can somewhat understand the reasoning to delay regular mammograms from age 40 to age 50 and then having them only once every two years (although I'm sure many women whose cancer was detected during one of these routine screenings may be baffled by that advice).
Mammograms expose you to radiation and if most of these screenings only lead to false positives and unnecessary biopsies, it may make sense to hold off until the risk of breast cancer is significantly higher.
But what really puzzled me is the panel's counseling against teaching women to perform breast self-exams.
Why preach against self exams? They're a do-it-yourself, not to mention free way of detecting early signs of breast cancer. What's the harm?
Roni Caryn Rabin did an excellent job of tackling that question in her article yesterday in the New York Times. (Read the article here.)
She points out that the two largest studies looking at whether self exams really work came up with disappointing results.
One study looked at 123,000 women in St. Petersburg, Russia, the other surveyed 266,064 women in China. The Russian women who were taught how to do self exams found more tumors, but there was no significant difference in death rates.
Same for the women in China -- even though one group was trained and even updated on how to perform the exams, breast cancer death rates between the trained and non-trained groups were virtually the same.
But, Rabin points out that researchers, even one who was involved in the original study on Russian women, now say the studies were under-funded and poorly done.
"It was not a good test of the approach," Dr. Anthony Miller, a Canadian researcher who was the World Health Organization's scientific adviser for the Russian study, told the New York Times.
And yet, the task force appears to have based its recommendation regarding self exams on these major studies.
Now, however, it seems the panel's members are eager to qualify their advice.
On Wednesday, Health and Human Services Secretary Kathleen Sebelius emphasized the task force does "not set federal policy and they don't determine what services are covered by the federal government." She advised women to "keep doing what you've been doing for years -- talk to your doctor about your individual history, ask questions, and make the decision that is right for you."
And Dr. Diana Petitti, vice chairwoman of the advisory group, qualified the panel's recommendations on self exams.
"Nothing in our recommendations says that a woman who finds a lump shouldn't go to her physician," Dr. Petitti, told the New York Times.
So, in other words, if you find a lump, by all means have it checked out. The panel just doesn't see any need to instruct women on how to find a lump.
Get it? No, me either.
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