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breast awareness, training in breast self-examination (BSE),and regular clinical breast examination (CBE) by experi-enced personnel (4). Breast awareness is a difficult conceptto measure, but it is clear that increased awareness hascontributed to a downshift in stage at diagnosis in theabsence of, or in addition to, that contributed by formalscreening (5). Although it seems reasonable that physicalexamination could be a pathway to earlier diagnosis inlimited-resource settings, at the moment, there are no ran-domized trial results establishing a mortality-reducingbenefit of BSE or CBE (6,7), so these approaches cannotbe recommended outside of the research/evaluationsetting. However, it would be useful to those planning