Thanks for the info.

Basically, there is no doubt for the importance of mammography and clinical examination as I have stated. There is few convincing data support for BSE (Breast self examination)which was the question point that I initiated the discussion with 纪医师.

I have seen questioning to the Shanghai and Russia study also.I agree that we should take a grain of salt for even the studies from the traditionally more "reliable" reports like another analysis done by Canadian Task Force on Preventive Health Care with very similar conclusion.However, the problem though remains is that there is no gold standard studies so far.

Anyway, from ACOG (American College of Ob & Gyn) recommendation, it is stated that "despite a lack of definitive data for or against breast self-examination, breast self-examination has the potential to detect palpable breast cancer and can be recommended." which is de facto the same as Harrison's as you have referred.

I think the recommendation is so far practical cause the consequence is too severe to bear with.

ACS (american cancer society)still recommend as an option along with the clinical exam by physician and mammogram.

Anyway, thanks for the contribution to this discussion. I will follow up on this further after I confirm with some experts.

More interestingly, whatever authority we may find. They may vary in their opinions though most of the time minor. That is why evidence based medicine do not put experts (even panel of experts) opinion as a highly regarded level in guiding clinical practice.

The bottom line is we are still lack of concrete evidence as of today for the contribution of breast self exam.

One thing that I may have to say and apologize is that: this discussion may involve too much technical details and controversial opinions that may cause more confusion to the public. I will further follow up and provide an clear answer and also like I stated before welcome many experts here provide me convincing and clear infos.

Thanks to X again.I believe we are here not only to criticize but also to learn from discussion.