Friday, November 20, 2009

Breast Cancer Screening Guidelines . . . What Do You Think??

As a young breast cancer survivor I am sure I will be in the minority when I say this but I am not alarmed by the new mammography guidelines released by the USPSTF. The recommended change is to increase the age from 40 to 50 for mammograms in otherwise healthy women. This debate has become so heated that even a well respected clinician like
Dr. Susan Love is getting alot of flack for her support of the recommendations. She addresses these issues on her blog. A great organization called Breast Cancer Action (BCA) includes their take on this issue via a statement on their website. They are one of the few in support of it as well.

I am an 8 year breast cancer survivor diagnosed at 31 years old. I was not at the age to get mammograms and did not have a significant family history of the disease. It was not something I thought about at all. That is until I found a lump in my breast. I went to the doctor who recommended a mammogram. No tumor was evident however the results came back revealing subtle architechtural distortion of the breast tissue therefore a biopsy was recommended. The diagnosis was Stage II breast cancer. I had a mastectomy, reconstruction and chemo. These days I go annually for mammograms as part of my post cancer followup. Mammography has been known to not be a good screening tool for young women because of the dense breast tissue. I have actually been told by a radiologist that my mammo's are almost impossible to read for that reason which leads me to question why I am having them done. Breast MRI is known to have a high false positive rate which is why it is not recommended for use in otherwise healthy women. I have had breast MRI resulting in a false positive which lead to an unnecessary biopsy. There is also the concern about radiation exposure from tests such as these causing cancer as the young age group is more suseptible to this than the older population. I have to admit this concerns me as well.

This change in recommendations does not address the lack of an effective screening tool for young women. Young women are in the same boat they were before as are most young adults. I think right now the most important thing women in our age group can do is be familiar with your breasts, know your risk factors, and if you find something abnormal get to the doctor and have it checked out. Kairol Rosenthal is the author of "Everything Changes: The Insider's Guide to Cancer in Your 20's and 30's". She is also in support of these guidelines and today has written a blog post more specific to the Breast Self Exam (BSE) aspect of those recommendations. I have shared my opinion with Kairol on that topic. Check it out here.

I think there needs to be less anger driven debates and more direction towards how we can reduce mortality rates in young women starting with finding a more effective screening tool for this population. I think that using an ineffective tool for lack of something better gives a false sense of security to the many women fearful of getting this disease.

How do you feel about the new guidelines? Do you think the debate has become too heated? Do you think people's reactions are fear driven? Where do you think the focus should be? As a young women what issue is most important to you regarding breast cancer screening?


Kairol Rosenthal said...

Cancer is so emotional, but we need to check our emotions at the door when we are reviewing scientific research. Your post is the most level headed clear thinking commentary I have seen in response to these guidelines. Instead of fighting science, we should embrace these new discoveries are important road signs that show us we should not spend our time going down dead end roads. Now we know that we instead need to chart new territories. I look at the recommendations as positive in that regard.


KK said...

I've been thinking about this a lot. It's good to hear from a young cancer survivor. I was thinking about some of the same things when I heard the news. My concern of course, is it gives insurance companies motivation to not pay for them before 50, when you might have concern, family history, etc. They look for any way to get out of paying things in my experience! Time will tell!

Cathy Bueti said...

Thanks for the comments girls! Kairol, thanks! And I so agree about embracing new discoveries and stop going down dead end roads.
KK...I understand you concern as well. Insurance companies are certainly known for any reason to get out of paying for a service! As you say...time will tell.