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Roger S. Foster, Jr, MD; John K. Worden, PhD; Michael C. Costanza, PhD
Vermont Regional Cancer Center University of Vermont Burlington

JAMA. 1987;258(10):1332-1333.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The article by O'Malley and Fletcher¹ is a careful and comprehensive review of the literature on the efficacy of breast self-examination (BSE). Since we feel their ultimate conclusion that BSE should not be advocated as a screening procedure for breast cancer is inappropriate, we would like to discuss two main issues.

The first issue is that we believe it is incorrect to consider BSE as only a consciously performed act and to try to distinguish breast cancers detected accidentally by BSE performers from those detected during formal periods of BSE. Because of the difficulty, and probably the irrelevance, of determining whether a cancer is detected during a formal BSE or "accidentally" between formal BSEs, we have used the category "self-detected" in our studies.² Among Vermont women performing monthly BSE, 90% self-detected their breast cancer, and 82% of women performing less frequent BSE self-detected their cancer, . . . [Full Text PDF of this Article]

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