Ten years later: an update of the case for teaching breast self-examination.

Breast self-examination (BSE) remains an appropriate area for continuing research. Nonetheless, it is now established that instruction by either a nurse or a physician, whether offered individually or in groups, and regardless of the details of the content or the teaching materials used, will result in a reported increase in frequency and proficiency. Less traditional instruction by means of the mass media also has been reported as effective. The actual competence in the practice of BSE remains questionable both because of inconsistency in the standards of practice and of reliance on self-reporting. The ultimate question related to the effectiveness of BSE in detecting tumors at a stage where the diagnosis is favourable remains uncertain. There have been some gains in knowledge during the last decade and the case for teaching BSE remains strong but its effectiveness is not yet unequivocally established.