Medical advice to women contradictory, confusing.(mixed messages on breast cancer screening)

2002 NOV 7 - (NewsRx.com & NewsRx.net) -- Call it the year of mixed messages: first came debate about mammography's value, then the news that long-term use of the hormones estrogen and progestin raise the risk of breast cancer and heart attacks after all.

Now more headlines, declaring that checking breasts for cancerous lumps once a month doesn't do much good, have some cancer patients and health care providers irate - and telling women to ignore the news and keep on checking.

"I'm on a rampage about the whole thing," said Sherry Goldman, a nurse practitioner who teaches breast self-examination at the University of California, Los Angeles, and who last year found a tiny cancerous lump in her own breast that a mammogram had missed.

"Women are very confused," added Dr. Gale Sisney of Georgetown University Hospital, who still advises self-exams. "We feel like we're getting ping-ponged around by these different messages."

Yet contrary to popular belief, the value of breast self-exams has long been in question. Federal cancer guidelines don't recommend them. National Cancer Institute (NCI) patient guides downplay them. So does the American Cancer Society.

Then a study of 260,000 women in China reignited the controversy. It concluded that women taught to carefully check their own breasts were no less likely to die of breast cancer than those who didn't, but that they did find more noncancerous breast lumps.

The bottom line: "Women should not feel guilty about not doing breast self-exam," said American Cancer Society epidemiologist Robert Smith.