Background: Women practice breast self-examination (BSE) according to their own schedule and skill. This variation in how BSE is performed has complicated the interpretation of studies of BSE efficacy and utilization.
Methods: We compared two methods commonly used to assess BSE competency, self-report of practice and ability to detect lumps in a model, among 81 women participating in a controlled toxicity trial of tamoxifen. Subjects were postmenopausal, were under 65 years of age, and had a history of breast cancer within the past 10 years but were currently free of disease. Women were asked to describe their usual BSE practice and were assigned a score (0-10) based on the number of recommended techniques and positions mentioned. Subjects were then instructed to examine a silicone breast model embedded with lumps (HealthEdCo) and to report any abnormalities.
Results: Overall proficiency was low by both measures. No significant correlation (r = 0.16, P = 0.15) was found between the two measures of proficiency. Higher correlations were observed among older women and among those practicing BSE monthly.
Conclusions: This study suggests that the two techniques are not comparably evaluating BSE proficiency. Further, both of these methods are likely to be poor measures of true BSE practice.