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Watch out, ladies. Alexa wants to make sure you check your breasts

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Mary Chris Jaklevic is a reporter-editor at HealthNewsReview.org. She tweets as @mcjaklevic.

A British breast cancer awareness group made news by announcing it developed a free app for Amazon’s Alexa virtual voice assistant called “Taking care of your breasts.”

A description of the app, available in the U.K., states:

“Breast cancer is the most common cancer in the UK. The lifetime risk of a woman developing breast cancer is 1 in 8.

“So it’s vital to check your breasts regularly for signs and symptoms of breast cancer.

“This tool guides you through what changes and signs to look for.”

But is it really “vital” for women to check their breasts regularly for signs of cancer?

No evidence for that claim was in a news release issued by Breast Cancer Care, the charity that created the app. The news release said the software “could help save women’s lives.”

The claim was repeated in an evidence-free story in the UK’s Sun, which was run by Fox News and the New York Post.

It’s one of many examples we’ve seen of credulous reporting about personal devices. We’ve written about overreaching medical claims for apps to control contraception, monitor heart rythyms, and check on postoperative wounds — to name a few.

We’ve also written about overblown claims regarding breast self-exams.

Breast self-exams are no longer endorsed

For the record, both the American Cancer Society and the U.S. Preventive Services Task Force – two organizations that issue cancer screening guidelines in the U.S. – dropped their recommendations that women conduct monthly breast self-exams years ago.

That followed studies showing regular self-exams did not affect breast cancer deaths but did increase harmful biopsies, as well as anxiety. Those potential harms weren’t mentioned in the news coverage or in the news release.

Those groups didn’t recommend against women seeing a doctor if they notice unusual changes. On its web site, the cancer society says: “Most often when breast cancer is detected because of symptoms (such as a lump), a woman discovers the symptom during usual activities such as bathing or dressing. ”

Similarly, the U.K.’s National Health Service advises women to be “breast aware.”

‘More wishful thinking than science’

The app’s description doesn’t specify how often women should check their breasts, but in a 2015 news release Breast Cancer Care said it was “urging women of all ages to get to know their breasts – ideally checking every 4-6 weeks.” It’s unclear what that advice is based on.

Karen Carlson, MD, director emerita of Women’s Health Associates at Massachusetts General Hospital, said in an email that she encourages women to “be aware of their breasts – but not to do a regular once-a-month self-exam. I also encourage women to come in for an exam if they have any concerns whatsoever about a change in their breasts.”

But she said that “doing monthly (breast self-exam) and thinking it will reduce the chance of succumbing to breast cancer is more wishful thinking than science.”

“Awareness of such symptoms and what they might mean is not a bad thing, but to say that Alexa’s reminders to do an exam regularly will ‘save lives’ from breast cancer is an overstatement,” she added.

Manipulative language

This dubious health claim is being promoted with manipulative language, including a message of empowerment.

Breast Cancer Care said it “hopes the tool will help women feel more confident about checking their breasts.”

Addie Mitchell, identified as a clinical nurse specialist at Breast Cancer Care, is quoted in the news release and the Sun article saying that “having Alexa on hand to guide (women) will help empower many with the confidence to build this potentially lifesaving habit into their routine.”

Richard Hoffman, MD, MPH, the director of the Division of General Internal Medicine at the University of Iowa Carver College of Medicine, wrote in an email: “Educating women about worrisome signs, including bloody nipple discharges and orange-peel skin changes, and advising them to discuss concerning findings with clinicians is reasonable advice.”

But he’s concerned about wording that implies — or directly states as the Sun article does — that women are failing if they don’t regularly check their breasts.

“This carries a rather negative connotation for not performing an exam for which there is no evidence of effectiveness,” Hoffman said.

Old ideas in new packaging

This isn’t the only software that encourages women to obsess over what are often normal changes in their breasts. We also found a breast self-exam app developed by Webfoot Technologies, a game developer known for Dragon Ball Z and Hello Kitty: Happy Party Pals. That app provides a tutorial and allows women to record “results” electronically using either a diagram or a photo.

While tech companies market their products as putting consumers on the cutting edge, in reality the effectiveness of health apps often isn’t backed by evidence.

A 1950 video promoted breast self-exams, which studies have shown don’t lower mortality.

And these particular apps appear to convey old-fashioned ideas. To see just how dated they are, check out this fascinating 1950 promotional film for breast self-exams produced by the National Cancer Institute and the American Cancer Society.

But be warned that this film resides in a historical archive for good reason. It contains inaccurate information about breast cancer, not to mention some truly outmoded fashion choices.

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