Breast self-examination: defining a cohort still in need.
BACKGROUND
The value of breast self-examination (BSE) to detect early breast cancer is controversial.


METHODS
Within an institutional review board-approved prospective study, 147 high-risk women were enrolled from 2004 to 2007. Yearly clinical examination, BSE teaching, and mammography were performed simultaneously followed by interval breast magnetic resonance imaging (MRI). Women underwent additional BSE teaching at 6 months. Women reporting a mass on BSE underwent clinical evaluation.


RESULTS
Fourteen breast cancers were detected in 12 women. BSE detected 6/14 breast cancers versus 6/14 detected by MRI and 2/14 by mammography. Of 24 masses detected by BSE, 6/24 were malignant. The sensitivity, specificity, and predictive value of BSE to detect breast cancer were 58.3%, 87.4%, and 29.2%, respectively. The sensitivity, specificity, and predictive value of a Breast Image Reporting and Data System (BI-RADS) score of >or=4 on MRI were 66.7%, 88.9%, and 34.8%, respectively.


CONCLUSIONS
BSE detects new breast cancers in high-risk women undergoing screening mammogram, CBE, and yearly breast MRI.
Duke University, Department of Surgery, Durham, NC, USA. wilke031@mc.duke.edu
Lee G
LG
Wilke
Gloria
G
Broadwater
Sarah
S
Rabiner
Elizabeth
E
Owens
Sora
S
Yoon
Sujata
S
Ghate
Victoria
V
Scott
Ruth
R
Walsh
Jay
J
Baker
Mary Scott
MS
Soo
Catherine
C
Ibarra-Drendall
April
A
Stouder
Stephanie
S
Robertson
Abbey
A
Barron
Victoria
V
Seewaldt
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D016504:Breast Self-Examination; D015331:Cohort Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D011446:Prospective Studies