May 2002    Vol. 1   No. 5


Preventive health care, 2001 update.  Should women be routinely taught breast self-examination to screen for breast cancer?  by Nancy Baxter in the June 26, 2001 issue of the Canadian Medical Association Journal found there is “fair evidence of no benefit, and good evidence of harm…” from BSE (breast self-examination) instruction.1 (See below to read entire study.) “To date, 2 large randomized controlled trials, a quasi-randomized trial, a large cohort study and several case-control studies have failed to show a benefit for regular performance of BSE or BSE education, compared with no BSE.  In contrast, there is good evidence of harm from BSE instruction, including significant increases in the number of physician visits for the evaluation of benign breast lesions and significantly higher rates of benign breast biopsy results ”  These recommendations reflect the commitment of the Canadian Task Force of Preventive Health Care.

The two most important studies that caused these prominent researchers to reach this conclusion are the Shanghai randomized controlled study of Chinese textile workers between the ages of 31 and 64 and the Russian/WHO randomized controlled study of women from Leningrad aged 40 to 64.  Both studies showed no difference between those who did self-examination and those who did not.  More biopsies for benign tumors were performed in those who faithfully did their examination.

In the Shanghai study, 133,375 women received education using silicone breast models, and personalized instruction.  They were compared with a similar sized group that received no instruction.  No difference in size or stage of the tumors was found between the groups.  In the Russian study, 122,471 women were divided into two groups.  One group was trained in small groups by doctors and nurses to perform BSE.  The other received no training.  There was no difference in tumor grade or mortality between the two groups.

COMMENT:  Breast cancer is the most frequently diagnosed cancer among women of Western societies.  Approximately one in eight women will develop this kind of cancer in her lifetime.  Because most women who develop breast cancer have no identifiable risk factors, early detection by means of mammography and BSE has become heavily promoted to save lives.  The effectiveness of mammography has been seriously questioned by the Cochrane Review (see the February 2002 McDougall Newsletter).  In this prestigious review, examination of the studies supporting mammography was found to be seriously flawed and biased towards benefits that really do not exist.

This current article reviews the research on BSE and comes to similar conclusions as the Cochrane Review for mammography: this examination also does not save lives and actually causes women harm.

The reason both BSE and mammography fail is it takes approximately 10 years for a tumor to grow to the size of detection (approximately ½ inch or 1 cm in size).  By this time, if the tumor is really cancer, it has already spread to other parts of the body, beyond the reaches of surgery and radiation.  Therefore, “early detection” is actually “late detection.”

So what harm can come from touching your breasts monthly?  If you find nothing suspicious then you remain unharmed.  However, if you find a questionable area then you are off on a journey that will likely cause you to never be the same again.  The least you will suffer is the worry that will haunt you until you are given a clean bill of health.   This worry may snowball into serious anxiety and depression.  Many unpleasant visits to your doctors’ offices usually follow your discovery.  If you need a biopsy, you will be left with a physical scar and maybe deformity.

If the worst happens, and you are diagnosed with cancer, then you become a “cancer victim.”  Now you are ineligible for health and life insurance and maybe unemployable.  People from that date on think of you first as a “cancer victim.”  The treatments that can follow have been described by some women as “hell on earth.”

To be fair, there are two advantages to finding a breast tumor early.  First, if you find it early then it is more likely to be smaller, which should lead to a cosmetically more acceptable surgery, like a lumpectomy.  Second, finding breast cancer will force many women to closely examine their diet and lifestyle and make long-overdue changes to a low-fat, plant-based diet and exercise.  There is very good evidence that a healthy diet will prolong the life of a woman with breast cancer (See the McDougall Program for Women book).

So now the Cochrane Review and the Canadian Task Force on Preventive Health Care have taken away your hopes and dreams of being saved by the medical business. What is left for you to do?  Your best chance to win the war on cancer is to eat a healthy diet (low-fat, no added vegetable oil, no cholesterol, high fiber, low-pesticide, plant-food based diet).   This is the McDougall diet that I have been teaching for the past 25 years.  Little has changed except for the number of people who realize the truth about the fallacy of the high-profit early detection business and the benefits of the no-profit, low-fat pure vegetarian diet and exercise program.  If only money could be made from the truth, then many more women and their families would be saved from this horrible disease and hellish treatments.


1) Baxter N. Preventive health care, 2001 update: should women be routinely taught breast self-examination to screen for breast cancer? CMAJ. 2001 Jun 26;164(13):1837-46.

Click here to read the entire study:


2002 John McDougall All Rights Reserved

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