Assessing breast self-examination

Background. Women practice breast self-examination (BSE) according to their own schedule and skill. This variation in how BSE is performed has complicated the interpretation of studies of BSE efficacy and utilization. Methods. We compared two methods commonly used to assess BSE competency, self-report of practice and ability to detect lumps in a model, among 81 women participating in a controlled toxicity trial of tamoxifen. Subjects were postmenopausal, were under 65 years of age, and had a history of breast cancer within the past 10 years but were currently free of disease. Women were asked to describe their usual BSE practice and were assigned a score (0-10) based on the number of recommended techniques and positions mentioned. Subjects were then instructed to examine a silicone breast model embedded with lumps (HealthEdCo) and to report any abnormalities. Results. Overall proficiency was low by both measures. No significant correlation (r = 0.16, P = 0.15) was found between the two measures of proficiency. Higher correlations were observed among older women and among those practicing BSE monthly. Conclusions. This study suggests that the two techniques are not comparably evaluating BSE proficiency. Further, both of these methods are likely to be poor measures of true BSE practice.