Can an instruction video or palpation aid improve the effectiveness of breast self-examination in detecting tumors? An experimental study

Abstract

Although large randomized trials have not shown benefits for breast self-examination (BSE), many organizations still endorse the practice. This study aimed to determine whether an instruction video or palpation aid improved the effectiveness of BSE. A total of 100 volunteers (50 men and 50 women) with no previous experience of BSE and/or clinical breast palpation were randomly assigned to the following intervention: instruction video seen versus not seen and use of palpation aids versus aids not used. Participants completed psychological trait and previous knowledge questionnaires before the intervention and/or breast examination. Examination was carried out on 24 different sized silicone breast forms, into 20 of which had been inserted tumor equivalents measuring 0.8-3.0 cm in diameter. The dependent variable was the rate of accurate tumor detection--the mean sum of correct positive hits (CPH)--defined as tumors detected within 20 s. Mean CPH values were then analyzed in relation to the interventions and other variables including gender and psychological measures (ANOVA and COVAR). Neither the instruction video nor interaction effects between gender and the instruction video influenced the mean CPH value. Furthermore, the palpation aid was strongly and significantly associated with a reduced detection (p=0.00003). Using an instruction video or palpation aid did not improve the effectiveness of breast examination in detecting tumors--a finding which supports results from large randomized studies. It is difficult to understand why BSE is still promoted by various groups.