ABSTRACT
This is a report of one of the only two randomized trials of breast self-examination (BSE) carried out in Shanghai, China; the other is the WHO trial in two cities (St Petersburg and Moscow) in Russia. In the Shanghai trial 267 040 female employees in 520 factories in the Shanghai Textile Industry were assigned during 1989-1991 on the basis of the factory in which they were employed to a BSE instruction group or as controls. Training in BSE was rigorous using silicone breast models, personalized instruction, video re-enforcement sessions and frequent reminders. A high level of participation was documented in the BSE group, and randomly sampled women in this group demonstrated greater proficiency in detecting lumps in breast models than did randomly sampled controls. Yet the number of breast cancers detected in the two groups to the end of 1994 was equal: 331 in BSE; 332 in control groups. Cancers detected in the BSE group were no smaller than those in controls, and cumulative breast cancer mortality rates over 5 years were virtually the same (30.9 versus 32.7 per 100 000). More benign lesions were detected in the BSE group (1457 versus 623).
