Interesting and good article. However, I have one point need to discuss with 纪先生.The latest Evidence Based Medicine review by Cochrane Database System Review in 2003:
(Kösters JP, G tzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database of
Systematic Reviews 2003, Issue 2. Art. No.: CD003373. DOI: 10.1002/14651858.CD003373)
Based on the author's opinion: "Data from two large trials do not suggest a beneficial effect of screening by breast self-examination whereas there is evidence for harms.
There were no randomised trials of clinical breast examination. At present, breast self-examination cannot be recommended."
There are other reviews with similar stats.(Screening for Breast Cancer, Joann G. Elmore, MD, MPH; Katrina Armstrong, MD; Constance D. Lehman, MD, PhD; Suzanne W. Fletcher, MD, MSc JAMA. 2005;293:1245-1256.)
However, in clinical practice here in the States that I have seen, physicians still instructed patients in self examination however more emphasize in routine clinical examination and mammography by the physicians which are more strongly supported by clinical evidences. Especially, screen mammography after age 40.
The problem of self exam may due to its large false positive results and thus it may not have any impact on reducing the mortality but just increase biopsy rate.
Anyway, just find this interesting and important to discuss in order to provide our readers the latest and most up to dated info. If 纪医师 know or find any different evidence based conclusions please let me know.