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Using an instruction video or palpation aid did not improve the effectiveness of breast examination in detecting tumors
Large
scale prospective-randomized trials have shown no benefit of breast
self-examinations (BSE) with respect to early detection of breast cancer.
In spite of this fact they are widely and highly recommended. Protagonists
argue that individual teaching lessons on palpation of breast lumps would
have changed the outcome of the trials. In order to investigate the
effectiveness of instruction videos or palpation aids we initiated a study
of 100 volunteers (50 men and 50 women) with no previous experience of BSE
and/or clinical breast palpation. They were randomly assigned to either
one of the following groups:
All
volunteers examined 24 different sized silicone breast forms, into 20 of
which had been inserted tumor equivalents measuring 0.8-3.0 cm in diameter.
The mean sums of correct positive hits (CPH; defined as tumors detected
within 20 second) were analyzed in relation to the interventions and other
variables including gender and psychological measures (ANOVA and COVAR). We
found that neither the instruction video nor interaction effects between
gender and the instruction video influenced the mean CPH value. The use of
palpation aids negatively influenced the detection rates (p=0.00003). This
experimental model supports the results from the large randomized studies
on BSE. Women confident of the value of BSE are either likely to falsely
imagine themselves to be safe or will be more likely to undergo
unnecessary surgical procedures. Protagonists of BSE should support their
recommendations by results of studies rather than personal beliefs. The results of a yet unpublished subsequent study in breast cancer patients proved our findings.
Bibliographical reference:
Karsten Münstedt Institute of Medical Psychology and Sociology of the Justus-Liebig-University, Giessen, Germany
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