ASK DR. ULISSEY

Q. My doctor recommends I do periodic breast self-examinations, like in the shower once a month, but what I read online is that the government task force does not.

A. I recommend that you do it. Maybe not every month, but every other month or so I think is a good idea.

Monthly breast self-examination and clinical breast examination by a doctor, or qualified alternate clinician, have been controversial. The fancy words are sensitivity and specificity. When a test (like a manual breast examination) is sensitive, that means it is very good at picking up a potential abnormality (in this case, a breast cancer). However, often the potential abnormality often does not turn out to be an actual cancer (fancy word = false positive). When a test is specific, that means that it does not always pick up a potential abnormality. But when it does, it is more likely that it will be a true abnormality (in our example, a breast cancer).

A manual breast self-examination, and even a clinical breast examination by a doctor, are neither sensitive, nor specific, but in my opinion, they are still useful. First of all, no medical test is 100 percent accurate. By doing a monthly self-exam beginning when you are young, over time your fingertips will remember what your breast tissue feels like. They will learn the various lumps, bumps and ridges that comprise your normal breast tissue, so that someday, 10 or 20 years down the road, you may be doing your exam in the shower and feel something “different.” Women’s intuition is good. If you do feel this and think it is different, get it checked out by your primary doctor, as well as well as a doctor at a full service regional breast center. Most of the time the extra checkup turns out to be normal, but sometimes, just by doing this easy monthly self exam, you might pick up something six months or a year earlier than when your next yearly mammogram is due.

Michael J. Ulissey, M.D., is a partner at the Breast Diagnostic Centers of Auburn and Federal Way. In addition to taking care of patients locally, he continues to participate in research as an adjunct professor at the University of Texas Health Sciences Center. You can reach him at Mike@breastdiagnostic.com.