Wednesday, December 15, 2010

Breast Cancer Recommendations

It has been the wellness-talk of the treadmill for the past couple of weeks.  I’m talking about the breast exam recommendations released by the United States Preventive Services Task Force. 

To sum it up, the USPSTF suggested baseline and follow up mammograms begin at age 50, instead of the current standard of 40, and to give up on Self-Breast-Examination (SBE).  Some folks have said that it’s high time we put the brakes on the aggravation and expense of — now what’s the term they use in the courts?  Ah yes, “frivolous” — screenings and scans.

After Thanksgiving dinner, as my cousins and friends were gathered round chatting about the matter, it came to our attention that four of the six women present had either found a cyst or found a malignancy.  Three out of four of us made the discovery before age 40.

The debate takes me back to a TV health show I participated in, right after the results of a Chinese study were released in 2003.  My friend Benita is a TV anchor for a local network affiliate, and also hosts a health talk show on public television.  When she called me and asked if I knew anyone who had been diagnosed with a breast cyst or breast cancer, and when she learned I fell into the former category, I became part of the talk show panel.

Here are the details of the 2002 study we discussed: 266,000 female factory workers in Shanghai (where mammograms are rare) were divided into two groups.  One group was taught how to perform SBE and reminded to do so regularly, and the other group was never even taught. After 11 years, there was no difference in the groups’ mortality rates due to breast cancer.

No difference in mortality rates means the group who enjoyed early detection had the same death rate from breast cancer as the group who didn’t.  Scary statistics.  We danced uncomfortably around that conclusion in our panel discussion, and stuck with beating the drum for early detection, support groups and accessible screening programs.

But scientists have known with some clarity for at least seven years now that SBE doesn’t improve your odds of surviving breast cancer.  You are just aware that you have it that much sooner.

That’s with SBE.  Now the task force says to put off the baseline screening for average, healthy adult women until 50 to avoid the discomfort, anguish, and over-treatment associated with repeat screenings and false-positives.  This is anecdotal evidence, of course, but my experience leads me to believe awareness is worth the anguish…especially if it leads to healthier lifestyle choices!

Quoting the chief medical officer of the American Cancer Society, Dr. Otis Brawley, “The USPSTF says that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age group. Yet USPSTF also says screening 1,904 women ages 40 to 49 in order to save one life is not worthwhile. The American Cancer Society feels that in both cases, the lifesaving benefits of screening outweigh any potential harms.”

So what say you?  Think about your sister, your daughter, your wife, your mother, your friend, yourself… your comments are encouraged.

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