[Breast self-examination also valuable in women participating in a screening programme]

To evaluate the different methods of detection of breast cancer in women who at time of diagnosis underwent screening mammographies as participants in the Dutch National Breast Cancer Screening Programme (BOB group), and in women who participated in an intensive screening programme for a familial or genetic predisposition to breast cancer (FAM group).

Partly retrospective, partly prospective, descriptive.

All patients who had surgery for invasive breast cancer at the VU University Medical Center, Amsterdam, the Netherlands, from 1 January 1995 to 30 June 2006 and who were participating in one of the abovementioned screening programmes at the time of diagnosis, were included. Data concerning the palpability of the tumour at time of diagnosis and the diagnostic method that first led to breast cancer being diagnosed, were collected.

The BOB group consisted of 397 women with invasive carcinoma of which 57% (227/397) tumours were palpable at the time of diagnosis. The majority (64%; 146/227) of the palpable tumours were discovered by breast self-examination as an interval carcinoma. 31% (71/227) were detected by screening mammography and were also palpable. During the same period, 490 women participated in the high risk screening programme; in this FAM group, 23 invasive tumours were detected. A total of 61% (14/23) of these lesions were found during breast self-examination; 7 lesions (30%) were found by imaging.

In women who participated in one of the 2 screening programmes, the majority of invasive breast cancers were palpable and more than half were detected by breast self-examination. Performing breast self-examination on a regular basis may contribute to early detection of breast cancer. Therefore, the teaching of breast self-examination to women should be encouraged, even if they are participating in a breast cancer screening programme.