A 180 on Breast Cancer Self examination

[DaemonSeid]

(CNN) -- A vacation to Washington nearly a decade ago led to a life-changing revelation for Kathi Cordsen. Passing by a breast cancer awareness event, her mother blurted it out: Her doctor had just confirmed that she had breast cancer.

She'd found the lump during a self-examination.

Fortunately, Cordsen's mom had found the cancer so early that she was able to have a lumpectomy and didn't need chemotherapy or radiation. That's why, today, Cordsen checks her own breasts every day in the shower.

"It was such an inspirational thing to find out that it saved her life, that's for sure," said Cordsen, 57, who submitted her story to CNN's iReport. "It's just important, to want to live and take care of yourself."


New guidelines from the U.S. Preventive Services Task Force say that women age 40 to 49 don't need to have routine mammograms anymore and that breast self-exams aren't recommended in general. The group found no evidence that self-exams reduce breast cancer death rates, and it discourages teaching women how to examine themselves.


New trends in self-exams

Although major cancer-awareness groups such as the American Cancer Society and Susan G. Komen for the Cure disagree with the new guidance on mammograms, continuing to recommend routine mammograms for women 40 and up, guidance on self-exams has been trending toward the task force's suggestions.

Both the American Cancer Society and the Komen foundation have been advocating that women be "aware" of their breasts rather than do a formalized self-examination procedure a few days after the menstrual period once a month.

The American Cancer Society makes no recommendations for how often or in what capacity a woman should check her breasts, just that she should be aware of any changes, said Dr. Len Lichtenfeld, deputy chief medical officer.

Being told to do this formal procedure resulted in "a huge guilt trip" for women who developed breast cancer, he said.


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Ladies, what do you think? Good advice or hooey?

[DrPhil]

I think these newer stories are confusing women.

Women should be aware of their breasts. Self-examinations and pay attention to tenderness even during your menstrual cycle.

And many of our gynecologists examine our breasts when we do our pap smears or have gyno visits for other reasons.

I think you should get mammograms if you have family history of breast cancer or are at the more prone ages for breast cancer.

[SydneyK]

Originally Posted by DaemonSeid

New guidelines from the U.S. Preventive Services Task Force say that women age 40 to 49 don't need to have routine mammograms anymore and that breast self-exams aren't recommended in general. The group found no evidence that self-exams reduce breast cancer death rates, and it discourages teaching women how to examine themselves.

Ladies, what do you think? Good advice or hooey?

I think the bolded part is hooey. The rest... well, I could probably be persuaded with the right documentation. I haven't heard/read enough to make an informed decision.

However, regarding the bolded, I can't see any benefit from discouraging women from performing BSEs. They're free and, if nothing else, they help women know if/when/how their breasts change. I've thought about this a lot since I heard it on NPR on yesterday's drive home, and I have not been able to identify one positive aspect of this new stance.

[DrPhil]

I think both men and women should examine their bodies and be familiar with their bodies enough to notice changes and go to doctor if necessary (beyond regular doctor visits).

Are men encouraged to perform self-scrotum exams? Not like you all need an excuse to hold your scrotum.

[WVU alpha phi]

These new recommendations are infuriating to me. My mother was diagnosed with breast cancer for the first time when she was 46. We had no previous cases of cancer in our family. She recognized a lump through a self exam and then went for a mammogram (and always went for annual mammograms too). If she had waited until she was 50 like these new guidelines are suggesting, I don't want to think what might have happened. My gyno has told me since my mom got her first diagnosis at a younger age and she was pre-menstrual, I should start getting annual mammograms as young as 30.

[AOII Angel]

As a mammographer, I am dismayed by the recent recommendations to change screening age to 50 and older. The American Cancer Society and The American College of Radiology continue to endorse screening beginning at age 40. I am especially surprised at the lack of concern over the idea of missing cases of cancer so that we can decrease the "mental distress" over false positive mammograms. I think women a resilient enough to handle false positive exams, undergo a negative biopsy so that other women can have their cancers diagnosed at an early stage.

As for self-breast exam...do it if you want. It doesn't improve survival in any study. If you are waiting until you can feel a cancer to treat one, you are treating it at a late stage. Mammography is designed to find tumors when they are invisible except for a few tiny calcifications in the ducts of the breast. There are many anecdotal stories of woman surviving after finding their breast cancers incidentally, but most women who find their breast cancers by self-breast exam are finding them late because they haven't been getting any health care, including mammograms.

[AOII Angel]

Originally Posted by WVU alpha phi

These new recommendations are infuriating to me. My mother was diagnosed with breast cancer for the first time when she was 46. We had no previous cases of cancer in our family. She recognized a lump through a self exam and then went for a mammogram (and always went for annual mammograms too). If she had waited until she was 50 like these new guidelines are suggesting, I don't want to think what might have happened. My gyno has told me since my mom got her first diagnosis at a younger age and she was pre-menstrual, I should start getting annual mammograms as young as 30.

Yes...you should start screening 10 years before your mom was diagnosed. You don't fall into the category of patients with no risk factors that would begin screening at age 50.

[33girl]

The part about women feeling "guilty" that they didn't examine their breasts correctly just sounds ridiculous. You can obtain shower cards at any ob/gyn that show you step by step how to do it. Oh, never mind, a dude said it.

[alum]

I think this is a dangerous trend. First we are told that self-exams are unnecessary and now mammograms?

Nothing in my genetic history or lifestyle choices would have increased my risk for BC yet I was diagnosed with BC just after my 43rd birthday. I noticed a lump while in the shower and had it examined ASAP through mammography and ultrasound. Whatever images the radiologist saw caused enough concern to require a core needle biopsy which confirmed the malignancy. After a lumpectomy, re-excision, chemotherapy, radiation, adjuvent drug therapy, and ultimately a bilateral mastectomy/DIEP, I am in remission. The oncologist recommends that my daughter to have a baseline mam when she is 23 (20 years younger than my age when diagnosed). I hope this recommendation won't change.

I wonder if insurance companies will cover mams for <50 women who think they feel something that ultimately turn out to be nothing or for young women with family history.

[AOII Angel]

Originally Posted by alum

I think this is a dangerous trend. First we are told that self-exams are unnecessary and now mammograms?

Nothing in my genetic history or lifestyle choices would have increased my risk for BC yet I was diagnosed with BC just after my 43rd birthday. I noticed a lump while in the shower and had it examined ASAP through mammography and ultrasound. Whatever images the radiologist saw caused enough concern to require a core needle biopsy which confirmed the malignancy. After a lumpectomy, re-excision, chemotherapy, radiation, adjuvent drug therapy, and ultimately a bilateral mastectomy/DIEP, I am in remission. The oncologist recommends that my daughter to have a baseline mam when she is 23 (20 years younger than my age when diagnosed). I hope this recommendation won't change.

I wonder if insurance companies will cover mams for <50 women who think they feel something that ultimately turn out to be nothing or for young women with family history.

Aren't you glad to hear that your cancer being discovered isn't worth the emotional stress of false positive mammograms in women under 50? How are you doing, by the way?! Haven't seen you around in awhile.

[alum]

Originally Posted by AOII Angel

Aren't you glad to hear that your cancer being discovered isn't worth the emotional stress of false positive mammograms in women under 50? How are you doing, by the way?! Haven't seen you around in awhile.

The last procedure resulted in major complications that required a 16 day stint in the hospital (7 in ICU). 150 leeches and 21 transfusions later, I am still in remission although there will be more surgery in a couple of months to correct the last procedure. Thinking about the LAT Flap...

[FSUZeta]

i am concerned that this is a precedent that is setting us up for rationed healthcare, should a universal healthcare bill be passed. if we get used to mammograms after 50 and every 2 years now, then rationing other procedures will be easier for us to accept.

i think that there are enough women whose lives have been saved by having a mammogram in their 40's that detected breast cancer, that the recommendation should stay as it is.

[Merci11]

Self-examination is how my mother discovered a lump that turned-out to be breast cancer, and at the time, she was only 35. What would have happened if she had waited 15 years to get that checked-out? I seriously doubt she'd still be alive.

And while self-examination doesn't lead to lower death rates, it does increase your chance of early detection, and usually, the earlier you catch the cancer, the better. You can probably wait on the actual mammogram unless you or your doctor feel the need to have it done, but there are so many women who develop this cancer before age 50, I think it would be dumb to not at least check yourself, regardless of what age you are.

[AOII Angel]

Originally Posted by alum

The last procedure resulted in major complications that required a 16 day stint in the hospital (7 in ICU). 150 leeches and 21 transfusions later, I am still in remission although there will be more surgery in a couple of months to correct the last procedure. Thinking about the LAT Flap...

OMG...I'm so sorry to hear that! I'm glad you're disease is in remission. Good luck with the rest of your reconstruction. Stories like yours makes me happy that one group doesn't get to make the rules for everyone...

[Kappamd]

The importance of self exams cannot be stressed enough, as has been mentioned numerous times.

My feeling, however, is that the incidence of false postive exams needed to be addressed through advancements in mammography technology and/or other diagnostic procedures before this study was done.

I know many groups have come out in opposition to the recommendation, including the American Cancer Society, but I would be interested to see the stance taken by the Susan G. Komen Foundation. I looked on their website, but they didn't seem to officially be taking a side either way.