Q: When should adolescent girls begin breast self-examination?
A: The major purpose of breast self-examination is to identify changes or new lumps in the breast that could signal the onset of breast cancer. Presumably, monthly exams on a regular basis will identify cancers at their earliest stage when they are most treatable.
However, the chances of a teen-age girl getting breast cancer are extremely low, so there is no exact age at which a young woman must start. Rather, we advocate teaching young women to examine their breast for four reasons. First, this approach will hopefully get them into the habit so that by the time they reach the age at which breast cancer becomes of concern, they are regularly following this important health practice. Second, it signals to the young woman that exploring one's body and becoming familiar with the changesthat occur during puberty are a natural part of adolescent development. Third, by teaching this method, we convey to teens there are positive steps they can take to promote their health. Finally, the discussion about breast examination may serve to open a dialogue among the teen, her parents and her physician about puberty and other related topics that might otherwise be ignored.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.