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Community Corner

Exams a Must for Detecting Breast Cancer

Start mammography screenings at age 40

Do it in the shower. Do it while getting ready for bed. Just do it once a month.

Get familiar with your breasts. Look for lumps, changes in size, shape or feel, and to see if there is any fluid.

All women should know their breasts and surrounding areas so they can be aware of changes, the American Cancer Society recommends. In Pennsylvania, experts predict 10,570 new cases of breast cancer to be diagnosed this year.

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“I encourage all of you to become an expert about the way your breasts look and feel so you can detect any subtle changes. After all, it’s our body, and we are the ones who have to live with whatever goes wrong with it,” said Jennie Yoon Buchanan, Medical Director of Women’s Imaging Services at Florida Hospitals.

It’s even more important that women in their 20s see a doctor for a Clinical Breast Exam every three years—and once a year after turning 40. Most doctors recommend annual mammograms for women 40 and older. Higher risk men and women should see their doctors more often.

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“Many breast cancers will be found in women who never felt a lump, because on average, mammography will detect about 80 to 90 percent of the breast cancers in women without symptoms,” said Kristina Thomson, executive vice president, interim, for the American Cancer Society of New York and New Jersey.

October is National Breast Cancer Awareness Month, and the idea is to educate women and men and to raise money for the cure. Sometimes women are afraid to go see their doctors, but this is the time to do it. Grab a friend and make appointments.

The American Cancer Society works closely with health departments and health care systems to provide free mammograms. Call 1-800-227-2345 for more information.

Developments in the medical field include diagnostic innovations, such as those found at New York-Presbyterian Hospital. The hospital is working on more early-detection procedures that are less invasive.

“Improvements in detection, as well as insights into surgical treatment options and their outcomes, have increasingly led to longer, improved lives for women with breast cancer,” said Dr. Andrew Seidman, who practices in New York and is part of the American Society of Clinical Oncology.

Dr. Gregory Harper, medical director of Breast Health Services at Lehigh Valley Health Network, said LVHN's position is the same as the American Society of Clinical Oncologists and the American Cancer Society: to begin mammography screening at age 40.

Harper said the question whether to screen before age 50 is not new. “They’ve been arguing that for as long I can remember and I’ve been in oncology for 30 years. A lot depends on how you ask the question.”

“Everyone, including the U.S. Preventative Services Task Force, says mammography starting at age 40 saves lives. So there’s no argument about that.”

The argument is between economics and values, Harper said. Is the cost of achieving that outcome worth it?

“The USPS Task Force argues there are too many false positives, particularly in the 40- to 50-year-old age group that leads to further work-ups, more imaging, biopsies” only to find out a tumor is benign.

“On that one, I’ve never met a woman who wouldn’t have rather had a false positive,” Harper said.

Harper said the question whether to give mammograms before age 50 is an emotional topic; the science is not contradictory.

“Mammography works and it decreases mortality. It’s more a values conflict than a scientific conversation. Some of us feel it’s worth saving lives between ages 40 and 50 and we don’t want to give up. If you stop screening, there will be more women who will die than if you hadn’t found the cancers earlier.”

Harper said if you ask the question based on overall population benefit to women between 40 and 70, “the relative benefit for women between 40 and 50 is much less than for women between 50 and 70. That’s because cancer is more common in women over 50.”

But, he said, “If you ask about life years saved, where’s the maximum benefit? It’s between 40 and 50. It’s for younger women. The life years saved is huge. The USPS Task Force did not ask that question.”

“The cancer [detected] between 40 and 50 contributes to life years saved much more than cancer found in women over 65.”

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