Another blow to breast feelies

Breast self-examination has been questioned for some time now -- on the grounds that it does more harm than good

According to a review by the Cochrane Collaboration, an international organization that evaluates medical research, there’s no evidence that self-exams actually reduce breast cancer deaths. In fact, the often-recommended monthly chore may even do more harm than good, according to the group’s analysis of a pair of studies of nearly 400,000 Chinese and Russian women.

“Data from two large trials do not suggest a beneficial effect of screening by (BSE) but do suggest harm in terms of increased numbers of benign lesions identified and an increased number of biopsies performed,” concluded the authors in Tuesday’s issue of The Cochrane Library. “At present, screening by breast self-examination … cannot be recommended.”

“I guess it’s one less thing that I need to be doing, but it is a little confusing,” says Liz Lane, a 29-year-old public relations manager from New York City. “Now I’m not sure what I am supposed to do to check myself.”

The issue is complicated, acknowledges Dr. David B. Thomas, breast cancer epidemiologist at Seattle’s Fred Hutchinson Cancer Research Center and professor of epidemiology at the University of Washington. “It’s important to separate out the public health implications from the implications for an individual woman,” says Thomas, who is also the author of the 2002 landmark study involving more than 250,000 Chinese women that was analyzed and affirmed by this latest review.

“If a woman is highly motivated — let’s say her mother or sister has been diagnosed with breast cancer — then of course she should practice breast self-exam. But that’s a different situation than trying to reach women on a mass scale. Our study shows that that’s probably a waste of time. You’re not going to get women sufficiently motivated to practice it well enough and frequently enough to make that big of a difference.”

What’s more, Thomas says BSEs can be problematic because the lumps and bumps women do report often turn out to be benign. “The price you pay for doing more thorough breast exams is you’re going to find more benign lesions and that will result in unnecessary surgical procedures,” he says.

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NYC inspectors know best

Especially enjoying all the freedoms of this fine country over the July 4th week end were all the immigrants and their descendants as they celebrated with glorious food from their ancestral homelands. And in New York City, with people from around the world, that could mean cannoli, cheesecake and croissants to name a few ethnic reats. Heaven, in other words, for me. But in over-bureaucratized, big brother New York City, a new insensitivity to the cultural food diversity of its citizens means that the local government is deciding that (grand)ma's recipes have too much trans fat so they're going to take it away from you. For your own good of course.

"How can that be when there is only butter in it [the croissant]?" asked Sarabeth Levine, owner of Sarabeth's on the upper West Side. Indeed, butter and other dairy products include trace amounts of natural trans fat. The tests cannot determine whether the trans fat found was man-made - like margarine - or natural.

Health Commissioner Thomas Frieden said the agency focus is on artificial trans-fat, but he noted, "Just because something doesn't have artificial trans-fat doesn't mean it's a health food. It means it doesn't have an artificial product in it that is going to make you more likely to have a heart attack."

Of course worrying about losing your livelihood because some city inspector grandly decrees your iconic products artificially violates city law does make it more likely you're going to have a heart attack. And not savoring your favorite food because a city commissioner, rather than mother, knows best will also increase your chances of having a heart attack. But

officials will not punish bakeries if they find more than .5 grams of trans fat, as long as it is natural trans fat, from sources such as butter.

Hey, thanks. Bon appetit in any language.

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