Breast Cancer Screening

November 23, 2009

Breast Cancer Screening

Recently the United States Preventive Services Task Force instituted a new recommendation for breast cancer screening.  You may have seen information on the news and internet regarding the disagreement between different medical groups’ recommendations regarding when to start breast cancer screening.

Last Monday, the U.S. Preventive Task Force released a new recommendation that women with average breast cancer risk should have mammograms every two years starting at age 50.  They also issued a statement that self breast exams are not recommended due to causing excessive anxiety and unnecessary breast biopsies.  This is a break with the American Cancer Society’s long-standing recommendation to initiate yearly mammograms starting at age 40 and to perform monthly self breast exams.

This has caused a lot of confusion for women. For years, doctors have educated women on the importance of breast cancer prevention. With a breast cancer prevalence of 1 in 8 women, most women personally know someone diagnosed with breast cancer.  Women have also been encouraged by their physicians to learn how to perform a self breast exam.  They have cards hanging in their showers reminding them of the proper technique. After forty, they dutifully schedule their mammogram yearly with their birthday so they don’t forget.  Now they are told that they may have been doing all this in vain?

First of all, if a woman has any question regarding when to initiate mammograms she should talk to her doctor.  Recommendations for cancer screening need to be individualized based on a patient’s set of risk factors.  What is appropriate for one woman may not appropriate for another.  As far as my patients with an average risk of breast cancer, I will continue to follow the recommendations of the American Cancer Society. I will continue to recommend yearly mammograms starting at age forty, as well as monthly self-breast exams.

As far as the Task Force statement that self breast exams are not recommended, I disagree.  Most of my patients with breast cancer have come to me after feeling a breast lump on their own.  While feeling a breast lump may cause considerable anxiety for a woman, it is my job to alleviate that anxiety and provide appropriate education and rapid evaluation of the condition.  I think it is unreasonable not to recommend a free and easy test that may be life-saving just because it may cause anxiety at times.  I believe self breast exams empower women to be in control of their health, and reminds them to develop healthy habits overall.

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