European Stars And Stripes (Newspaper) - May 19, 1987, Darmstadt, Hesse                                Breast examination How effective is it by Nadine Brozan new York times very month she conscientiously examines her breasts searching Tor minuscule lumps and scrutinizing herself in he Mirror to see in there Are any changes. Could she some Day save her own life by finding a tumor in its earliest most treatable stage the effectiveness of breast self examination has yet to be determined according to a report in the april 24 Issue of the journal of the american medical association. The paper Willen for the United states preventive services task Force which was appointed by officials at the department of health and human services is a review of More than 300 scientific studies conducted in the past 15 years. As a Way to detect breast cancer the report concluded self examination has potential but Many unanswered questions remain and require scientific investigation before this procedure can be advocated either As a supplemental or As a primary screening test for breast  the problem with self examination the report said is not evidence of a Lack of effect but Lack of evidence that is there is no Long term proof that sell examination either does or does not save lives. Many members of Tho Public Ware confused by the report. Among doctors and researchers there was widespread approval of its recommendation Lor further research but concern that women might take the findings As a signal to abandon self examination of their breasts. Tim american cancer society estimates that by the end of his year 39,900 women will die of breast cancer which kills More women than any cancer but lung cancer. No Way of preventing breast cancer has been found and no certain cure exists. Early detection remains the single Best Hope but Many physicians polls show do not encourage patients to Lolkje a regular screening program or to have Marne Grams breast a rays. Ii was a shame that the report was Ever published. And i think she Public ought to ignore the findings said or. Charles r smart chief of the Early detection Branch division of cancer prevention and con tit. Of the National cancer Institute at Bethesda my. Seventy to 90 percent of All women who have had breast cancer have Lound their own lumps and than gone to doctors for confirmation. So anything that discourages women from examining themselves is detrimental. We do know thai in Genera sell examination picks up earlier disease smart said. The cancers Are Small and less frequently involve Lymph nodes. There is less evidence of Extension and the survival rate is better among women who have done it than among Hose who Haven  annual physicals and mammograms remain she most reliable detection methods smart end other experts said but some fast growing tutors can Spring up Between examinations. How much patients Benefit from the Early detection of those tutors was a Point of debate in Many of the studies such tutors Are believed to be faster growing and More aggressive than some others and thus Are already beyond the stage when they can be easily treated some experts suggest. Or. Samuel Heilman the physician in chief at the memorial Sloan Kettering cancer Center and a radiation oncologist said this should not be a deterrent. Ii is True that interval tutors can be worse he said but that does not mean it is not Good to find them As Early As   criticized scientific aspects of the report and questioned whether the proper criteria had been used to assess self examination in addition the paper did not explain How the women in the 300 studies surveyed had been tested for breast cancer. Or. Suzanne w. Fletcher a professor of Medicine at the University of North Carolina and a co author of the paper in the medical association journal said that Many of the studies cited had made no distinction Between women who had used Only self examination and those who had performed it in conjunction with regular clinical examination and mammography. As a result it was unclear what was being assessed in the report the ability of self examination to save lives Independent of other measures or its value As a ways to protect yourself new York timezone of every 10 american women Wilt develop breast cancer according to the american cancer society. The most effective ways for women to protect themselves Are with professional examinations and sett examinations at a prescribed time every month according to the society. In suggests these Steps a Mammogram breast a Ray should be taken Between the Ages of 35 and 39, to be used later Tor comparison. A doctor should examine the breasts every three years when a woman is Between the Ages of �0 and 40, and every year a or 40. Women with no symptoms should have a Mammogram every year or two Between age 40 and 49, Ana every year after 60. Women of any age with a history of beast cancer a Strong family history o he disease or other Risic factors should consult a physician to determine a schedule for . All women Over 20 should develop the habit of examining their breasts monthly. Supplement. Still he can said he considered the report a dispassionate and dear  ii does not say thai breast sett examination is not Van. But that the data to support its use do not exist  said. The main difficulty is that there have been no controlled prospective clinical trials. Several such studies of the effectiveness of Easl sail examination Are under Way and a Larga Schfe study has been started in Moscow and in Leningrad As a joint Effort of the soviet Union and the Wood health organization. It will eventually involve 230,000 women. In the meantime specialists at the american cancer society the National cancer Institute and such institutions As the Aultman Institute and the memorial Sloan Kettering cancer Center Hava urged women to perform sell examinations regularly. As or. Phillip Strax founder of the Aultman Institute in new York and the Strax Institute in fort Lauderdale fla., said we know that by itself breast serf examination is not going to find those cancers that Are not palpable. But there Are important values in teaching breast self examination. You Alert women to the need for professional palpation and Marumo Greeny he said. And no matter How we conduct the exam with no lamest equipment and the most expert lingers we will miss 5 to 10 Percone of breast cancers that Are present but not yet developed to the Point that they can be detected. Some of those do become detectable in the year that a woman has of wait Tor her next clinical exam and  a dissenting View was expressed by or. Susan m. Love director of he breast dime at Beth Israel Hospital and a surgical oncologist Al the Dana Farber cancer Institute both in Boston. The reality in that most breast cancers cannot be Felt in their Earty stages she said. What you Leaf is not the cells themselves but the i bionic reaction the hardening that they cause and when the cancer is very Small there is not enough reaction to  women often worry about missing a tiny Grain love said feeling that they could be dooming them serves and that it would be their own fault. She said she did not recommend that women give up self examination but rather that they simply familiarize themselves with Ait those Little grains and bus that Are Normal for most women the Issue remains irrelevant they do not perform sell examinations or have mammograms. As Marjorie Small program coordinator for Mamma care at mount Sinai Hospital part of a National Chain of instruction centers put i. Unfortunately we Don t see Many women maybe an average of to a month. 1 wish it were More but it s a hard thing to sell. I think that s because women Haven l been properly taught Haven t Beon encouraged by the metrical Community. Most doctors do not spend enough time discussing it she said. In tact studies show that by and Large Many doctors Don t do adequate breast  Page 15 the stars and stripes tuesday May 19,1937