Joy Victory is deputy managing editor of HealthNewsReview.org. She tweets at @thejoyvictory.
This week a Facebook post from user Hayley Browning on her “trick” to finding breast cancer went viral, garnering 150,000+ shares, and 22,000 comments in just a handful of days.
“3 weeks ago, I was diagnosed with Breast Cancer. I could only feel the lump whilst lying down and it completely disappeared standing up. …this is a call out to all women to check for lumps lying down, as well as standing up,” her post states.
In the era of heated political rhetoric, it’s impressive to see a post about basic health information do so well.
Yet–you knew there was a yet, didn’t you?–we also cringed just a little, especially as we skimmed CBS News’s write-up on the post. We expected that their story would flesh out Browning’s post, which, after all, is her personal opinion–she’s not a medical expert, and hopefully her Facebook readers realized that and took her advice with a grain of salt. But CBS didn’t elaborate on the pros and cons of breast self-exams; instead, it just added a little bit more on how to do one.
This was a missed opportunity to provide context because in reality the evidence doesn’t support regular breast self-exams as being useful (which goes against what many women are told every day from their doctors), and there are other, important things women should know about breast cancer prevention.
We want to be clear that this is no way a criticism of Browning, who is obviously dealing with a difficult situation and trying to make something positive out of her ordeal. We wish her the the best on her treatment. Our concern relates to the framing of her message, and what journalists could have done to scrutinize and improve that framing.
“While it’s important for women to understand what feels normal when it comes to their breasts, just doing a breast self-exam alone is not enough to reduce their chances of dying from breast cancer,” explains Mandy Stahre, PhD, an epidemiologist at the Washington State Department of Health as well as a breast cancer survivor who has served as a consumer reviewer for the Department of Defense Breast Cancer Research Program.
The evidence is so weak that the U.S. Preventive Services Task Force recommends against them, explaining “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”
This position is supported by the National Breast Cancer Coalition, which states “in addition, there are some data that show that breast self-exam greatly increases the number of benign lumps detected, resulting in increased anxiety, physician visits, and unnecessary biopsies.”
But Stahre and other breast cancer experts we spoke to agreed that, in general, it’s good for women to have a sense of what’s normal for their breasts (and their bodies), and that doctors should help patients understand what this means.
“Many of my colleagues still encourage women to be ‘breast self-aware,'” said Dr. Deanna Attai, MD, assistant clinical professor of surgery at the David Geffen School of Medicine at the University of California Los Angeles and past president of the American Society of Breast Surgeons. “I think it is irresponsible for any physician to encourage a woman to simply woman to simply ignore their breasts–we don’t tell people to not check their skin lesions, ignore changes in GI patterns, etc.”
But while knowing one’s body is a good thing, what’s not good is when women feel that they have to “go on a monthly search and destroy mission to find a lump,” said Christine Norton, a patient advocate with the Minnesota Breast Cancer Coalition, paraphrasing the advice of breast cancer expert Dr. Susan Love.
Along with general breast awareness, and engaging doctors in consversations about the risks and benefits of different forms of breast cancer screening, the experts we spoke to also think there should be more communication about modifiable risk factors.
What are those things? Stahre put together this list for us–one we think is worth sharing:
“So many women I’ve spoken with since my diagnosis in 1990 say ‘there’s nothing I can do. I’m convinced I’ll get breast cancer’ … there ARE quite a few things that research has repeatedly shown will help to lower one’s risk of breast cancer,” Norton said.