A large well conducted randomised controlled trial from Shanghai shows conclusively that teaching women how to examine their breasts does not lead to a reduction in mortality due to breast cancer compared with no screening at all.1 The findings should bring to an end more than decade of controversy and confusion in the United Kingdom concerning the efficacy and effectiveness of self examination of the breast.

In September 1991, in his retirement speech, Chief Medical Officer Sir Donald Acheson announced that breast self examination was not effective and may give a false sense of security. His remarks outraged women's health campaigners, fuelled by a media frenzy in favour of breast self examination that lasted several weeks. The introduction of a policy of breast awareness shortly afterwards only added to the confusion. Rather than ritually checking their breasts at a specific time each month according to a set technique, women were encouraged to take responsibility for their own health by taking convenient opportunities such as bathing or dressing to become familiar with their breasts at different times of the month and …