ASSESSING BREAST SELF-EXAMINATION

Background. Women practice breast self-examination (BSE) according to their own schedule and skill. This variation in how BSE is performed h as complicated the interpretation of studies of BSE efficacy and utili zation. Methods. We compared two methods commonly used to assess BSE c ompetency, self-report of practice and ability to detect lumps in a mo del, among 81 women participating in a controlled toxicity trial of ta moxifen. Subjects were postmenopausal, were under 65 years of age, and had a history of breast cancer within the past 10 years but were curr ently free of disease. Women were asked to describe their usual BSE pr actice and were assigned a score (0-10) based on the number of recomme nded techniques and positions mentioned. Subjects were then instructed to examine a silicone breast model embedded with lumps (HealthEdCo) a nd to report any abnormalities. Results. Overall proficiency was low b y both measures. No significant correlation (r = 0.16, P = 0.15) was f ound between the two measures of proficiency. Higher correlations were observed among older women and among those practicing BSE monthly. Co nclusions. This study suggests that the two techniques are not compara bly evaluating BSE proficiency. Further, both of these methods are lik ely to be poor measures of true BSE practice. (C) 1995 Academic Press, Inc.