Breast cancer can be detected early using different methods. The tactile examination still plays an important role. Sometimes the fine sense of touch of blind women is also used.
Reichenbach – Christine Kanetzki proceeds very cautiously. She spends almost an hour with her patient, feeling every centimeter of her breast with her fingers. She also feels the lymph nodes in the neck, collarbone and armpits.
And she gets an overview of the temperature, shape and tissue strength. “It’s like an inspection,” says Kanetzki. The blind woman has been working as a medical tactile examiner (MTU) for almost ten years. She offers a detailed palpation examination of the breast, the so-called tactilography, in gynecological practices.
Recently she has been employed in the care center of the Paracelsus Clinic in Reichenbach, Saxony. She also works with practices in other cities in the region. “The sense of touch that we have cannot be studied. As blind people, we depend on him every day,” she says. Being able to read Braille, which involves feeling small dots with your fingers, is a good prerequisite for this job. It is organized by Discovering Hands Service GmbH, which was founded in Mülheim an der Ruhr (North Rhine-Westphalia) in 2011. The social enterprise has already trained almost 60 blind or visually impaired medical tactile examiners (MTU), says Frank Hoffmann, founder and idea generator.
Many knots found in gynecological practices are already one to two centimeters in size, explains the specialist in gynecology and obstetrics. “I used to be dissatisfied, in everyday practice we only have little time to feel the breast.” According to their own studies, the trained blind women can detect changes from a size of 0.6 centimeters. The fact that blind people and their sense of touch are of any use in cancer prevention has often been doubted, says Christine Kanetzki. “The doctors now trust me. When I feel small changes, they initiate further steps.”
Tactilography is recommended once a year, says Kanetzki, who was the only MTU in Saxony for a long time. “A lot of women come to me regularly. Former breast cancer patients also use this type of further screening. And there are normal tissue changes in the breast that can be scary, but which we can distinguish well with our sense of touch.” Frank Hoffmann clarifies that MTU is to be understood as a medical assistant. “The findings are handed over to the doctors. They evaluate him, make the final diagnosis and decide how to proceed.”
Susanne Weg-Remers from the German Cancer Research Center in Heidelberg assesses the range of services offered by tactilography as a supplement to early cancer detection and is comparable to a tactile examination at a gynecologist’s. At the same time, it dampens expectations: “Unfortunately, there is no scientific evidence that it can reduce the mortality rate of breast cancer patients as part of serial examinations.”
“The cancer must have reached a certain size before you can feel it.” Tactilography is therefore only recommended as an additional option for women between the ages of 50 and 69. “It cannot replace mammography, i.e. a special X-ray examination of the breast,” explains Weg-Remers, head of the cancer information service. Only this has been shown to reduce mortality from breast cancer.
Blind or visually impaired women who are organized through Discovering Hands go through a ten-month qualification under medical supervision, Hoffmann explains his concept. The training is supported by rehabilitation providers, foundations and on a scholarship basis. In addition to the Vogtland, there are also medical-tactile examiners in Dresden, Leipzig and Chemnitz in Saxony. According to Hoffmann, 31 statutory and all private health insurance companies are now covering the examination costs.
When it comes to the sensitive topic of breast cancer prevention, Susanne Weg-Remers states: The German Cancer Research Center recommends regular early breast cancer detection. “But no research is 100% reliable. All of them are at risk of false alarms.” Subsequent invasive tests such as a biopsy carry additional risks. “They can lead to bleeding or infection. And not every tumor found would have developed aggressively – one speaks of an overdiagnosis. Nevertheless, all patients then go through cancer therapy, which is not always clear as to whether it would have been necessary.” Therefore, it remains a personal decision as to which early detection examinations a woman takes advantage of. dpa
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