I am 28 years old and a 20-month survivor of stage I invasive ductal carcinoma. I found my lump through breast self-examination at the age of 27, 13 years before the recommended age for baseline mammography. Mammography and ultrasound of the lump revealed no abnormality. It was not until excisional biopsy was performed that the correct diagnosis was made. Clearly, breast self-examination saved my life.
Women under the age of 40 years are not receiving adequate attention from the medical community. There are few studies focused on women in this age group. The recent article in CMAJ on breast self-examination avoided making recommendations for young women owing to “the lack of sufficient evidence to evaluate the effectiveness of the manoeuvre” in women younger than 40 years.1
Young women's breast tissue is often too dense for mammography to be an effective diagnostic tool. While the clinical breast examination is key to early detection, there is an inherent flaw in that the physician is not familiar with an individual woman's breasts. That leaves breast self-examination as our most powerful tool for early detection.
Signature
Tracy Highton
Lawrenceville, Ga.
Reference
- 1.Baxter N, with the Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update: Should women be routinely taught breast self-examination to screen for breast cancer? CMAJ 2001;164(13):1837-46. [PMC free article] [PubMed]