ECU research team publishes findings on breast self exam

Three East Carolina University researchers who have conducted long-term surveys with eastern North Carolina women found that proper breast self examinations are not uniformly understood or practiced.

The findings, published in the July/August 2005 issue of Journal of Women’s Health, are based on surveys of more than 1,000 women from 10 eastern North Carolina counties age 50 and older who report that they routinely examine their breasts for lumps or changes.

The ECU team is composed of Dr. Jim Mitchell of the Department of Sociology, Dr. Holly Mathews of the Department of Anthropology, and Dr. Linda Mayne of the School of Nursing. Their study sought to explore the potential of breast self exam to reduce proportionately higher breast cancer mortality among African-American women compared to Caucasians. Researchers found that Caucasian women were more likely than African-American women to report tactile examination of breast tissue with their fingertips to find breast lumps or tumors. Alternatively, African-American women were more likely to report examining their breast tissue visually in the absence of tactile examination.

The findings are part of a larger project spanning nine years that tracked changes in mammography use in women age 50 and older, Mitchell said. Mitchell and Matthews have collaborated on projects concerning behavioral health for about 20 years. Mayne joined the team about 10 years ago.

“In general, human health behavior is complex and understood best when the perspectives of several researchers from various disciplines are combined,” Mitchell said.

The ECU researchers plan more studies on breast self exam, although federal funding for their work has been difficult to find. Some health care agencies, based on trials in China and Russia, have recommended that women no longer perform routine breast self exam. The ECU researchers disagree and say more work is needed.

“It points out that there is a deep-seated bias about the effectiveness of breast self exam in the clinical research community because, to a great extent, its effectiveness has never been studied systematically, particularly in more vulnerable populations,” Mitchell said. “We assume far too much about what women know and do about breast cancer screening.”

An editorial co-written by Dr. Donald Lannin, former director of the Leo Jenkins Cancer Center of the Brody School of Medicine at ECU, accompanies the ECU researchers article in the Journal. Lannin is now associate director of the Yale-New Haven Breast Center of the Yale University School of Medicine. Lannin points out that although breast cancer incidence is not as high in African-American women compared to Caucasian women, breast cancer mortality is higher. Also in the past decade, breast cancer mortality has decreased in Caucasian women to a greater extent than in African-American women so that the racial “gap” in breast cancer mortality is actually increasing. With women in the United States finding almost 70,000 cancers each year through breast self exam, Lannin said that proper breast self exam and early detection should continue to be promoted.

The Journal of Women’s Health is a multidisciplinary peer-reviewed journal which publishes clinical papers on health issues that affect women across the lifespan.