[Randomized trial of breast self-examination in 266,064 women in Shanghai].
OBJECTIVE
A randomized trial of breast self-examination (BSE) program was carried out to evaluate whether the intensive BSE can reduce the death number of women from breast cancer.


METHODS
A total of 266,064 women (age of 30 to 64 years) associated with 519 textile factories in Shanghai had been randomly assigned to a BSE instruction group (132,979 women) or a control group (133,085 women) since 1989. Initial instruction in BSE group included demonstration of proper palpation techniques. It was followed by 2 reinforcement sessions during the subsequent 4 years including video shows, BSE instruction sessions and BSE practice under medical supervision. These activities were continued for 5 years. Attendance at all events was recorded. The cohort was followed through July 2000 for development of breast diseases, and the breast cancer cases were followed up through 2001 for vital status. The data analysis methods used included Kaplan-Meier plots, Log-rank test and Cox modeling.


RESULTS
Among women under instruction, 864 breast cancers were detected and 133 breast cancer deaths occurred, and 896 breast cancers were detected and 130 deaths recorded in the control group. The tumor size (P = 0.07), TNM stage (P = 0.39) and cumulative breast cancer mortality rate (P = 0.72) were not significantly different between the 2 groups. However, more and smaller fibroadenomas were detected in the instruction group than in the control group (P < 0.01).


CONCLUSIONS
Intensive instruction in BSE can not reduce mortality rate of breast cancer, but more and smaller benign breast lumps can be detected.
Gao
Dao-li
DL
Department of Epidemiology, Zhongshan Hospital, Fudan University, Shanghai 200052, China. daoligao@eastday.com
Thomas
David B
DB
Ray
Roberta M
RM
Wang
Wen-wan
WW
Allison
Charlene J
CJ
Chen
Fan-liang
FL
Porter
Peggy
P
Hu
Yong-wei
YW
Zhao
Guan-lin
GL
Pan
Lei-da
LD
Li
Wen-jin
WJ
Wu
Chun-yuan
CY
Coriaty
Zakia
Z
Evans
Ilonka
I
Lin
Ming-gang
MG
Stalsberg
Helge
H
Self
Steven G
SG
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D016504:Breast Self-Examination; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D008875:Middle Aged