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Breast cancer is the second leading cause of cancer-related deaths in women, however questions have been raised about the screening programme in place and in light of the early age at which breast cancer can present, is self examination good enough or should we be looking at other screening tools.

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Womens risk of breast cancer varies and those at high genetic risk – should seek specialist advice as presently there are many research programmes and opportunities to support these women however for the rest of us – especially when screening programmes in the UK do not start until we are 50 years old, should we consider something else.

Early detection improves outcome and also allows choice in treatment so this has got to be beneficial test.

Presently mammography is the commonest screening tool, however in pre-menopausal women, as breast tissue is thicker in women who are exposed to oestrogen, this has not been an effective tool and is the primary reason why breast screening starts at 50 years, although with more effective mammography this is being reduced.

Other techniques include ultrasound, magnetic resonance imaging but should we forget the simple breast self examination technique.

No technique is 100% effective and all techniques do have false positives – when we find something which turns out not to be breast cancer. Self examination is no different, we will miss things or not detect things and some things we notice will not be cancer.

Don’t forget the important rules: Remember always seek medical advice if you find a lump, you notice a change in your breast or nipples ie they are red, swollen, the skin becomes dimpled or the nipple becomes inverted, painful or leaks fluid. You should also ask for advice if you notice any lumps in your arm pits.

Breast self examination, however remains a tool which all of us can use but there is debate. The National Breast Cancer Foundation, state up to 70% of breast cancers are found by women performing their own breast examination, although other studies show that there was no improved detection of breast cancer when given instruction on self examination and therefore agencies such as The Canadian Taskforce on Preventive Health Care no longer recommends the use of BSE for breast cancer screening and feel that increased anxiety do not give enough benefit. The Department of Health has taken a neutral stance on self examination.

Personally, I feel breast awareness is important – it allows us to remain in control and enables us to be self aware, although will not hold all the answers. The precise technique and whether it should be done regularly, is probably not as important as being able to recognise if a change has occurred.

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