KnowYourBreastCancerRisk.com

The US Preventive Services Task Force changes everything and I am getting angry!

In the November 17 issue of Annals of Internal Medicine, (see www.annals.org), the U.S. Preventive Services Task Force (USPSTF) radically changes its recommendations on screening for breast cancer. For ever, the recommendation was for women 40-49 years old to have a Screening mammography every 1-2 years and for women 50 years and older to have a mammography once a year.

Most OB/GYNs will send their patients once between 35 and 40 years old. Now, the USPSTF recommends against routine screening mammography in women 40 to 49 years unless there is a good reason to get one. Routine mammography may create more harm than good. It may lead to anxiety and unneeded biopsies. So, don’t do them.

In addition, the USPSTF recommends every other year screening mammograms for women aged 50 to 74 years and no routine mammography for women over 75.

Next is the best of all. The USPSTF recommends against teaching breast self-examination.

So, if I understand this…don’t get a mammo until age 50 if nothing is going on. Get one only if there is a reason. Don’t do breast self-exams. So, even if there is something going on you will not find it.

Do you think that insurance will stop paying for mammography now?

Do you think this new concept will save lives? Or will it just save healthcare dollars?

Will your anxiety be more or less if you know you are doing nothing?

Are you telling me that you know no one with breast cancer under 50?

Mammographies miss 10% of breast cancers, maybe more. But not even trying gets me angry.

The idea that abnormal cells are present within your breast may cause a lot of anxiety. The reality is that the diagnosis of atypia is a window into the cellular activity in our breasts. A window we really never had access to before. This window may allow us to see small changes well before they become cancer. Most women would rather know that they are more susceptible to develop breast cancer so that they can be followed more closely.

The finding of atypia is considered in the context of your health history and other family history but may increase your breast cancer risk 4-6 fold. The most important thing to do with this information is to find a breast specialist who can partner with you to minimize the risk of this developing into anything more serious.

Also, know that there are several positive interventions that we may make to reduce your risk even in the face of atypia. Science has allowed us to see things well before we can see them on an x-ray. Using this information and making positive changes may afford us the opportunity to halt the progression of these changes!

This is a great question and has recently become a passion for me, because I really think we are what we eat and diet has a tremendous role in breast cancer!

Realize that only 7-10% of breast cancer is hereditary and so there are other important factors in our day to day life that may predispose us to develop breast cancer.

Several studies have pointed to a role of high fat diets in different cancers across the board and also in breast cancers. Also, studies show that being overweight or at an unhealthy weight increases both the risk and the survival of breast cancer.

Physical activity may also play a role in both the prevention and improved survival for breast cancer. All that in context, we need to eat more fresh fruits and vegetables, less red meat, less processed foods and reduce our total fat intake to less than 15% of our dietary calories.

These are truly lifestyle modifications but will make us healthier on multiple levels both with other chronic diseases such as diabetes and cardiac disease as well as breast cancer. Many physicians are not adequately trained or do not have the time to make such dietary interventions, but may partner with registered dieticians in their community to optimize the health of their patients and their community!

Working together, we can educate patients as to their ability to control their medical future!