I had breast cancer twice before 40 and found it through self-exam. The updated mammogram guidelines will save lives.
I had breast cancer two times, at 35 and 39. Both times, I found it myself.
Both times I had it, I was younger than the age people typically started having mammograms
Updated guidelines recommend people have mammograms at 40, and I think this is a good step.
I was diagnosed with breast cancer for the first time when I was 35 years old. My genetic tests were negative, I didn't have any major risk factors, and I didn't have a family history of breast cancer. I was among the patients considered to be of "average risk." I often tell people that I had no business getting breast cancer but that breast cancer didn't care; I was among the one in eight women who will be diagnosed in her lifetime.
At the time of my first diagnosis, I was considered "too young" for routine mammograms. I chose to have a mastectomy, yet breast cancer wasn't finished with me. I was diagnosed for the second time when I was 39. Both times, I discovered my breast cancer through look-and-feel self-breast exams.
This week, the US Preventive Services Task Force made a new and bold in-the-works recommendation. The updated recommendations say all persons assigned female at birth should "get screened for breast cancer every other year starting at age 40 to reduce their risk of dying from the disease." Its prior recommendation was for those 50 to 74 to have a mammogram every two years.
The Centers for Disease Control and Prevention says about "9% of all new cases of breast cancer in the United States are found in women younger than 45 years of age." Younger patients are "likely to be found at a later stage" where the cancer is "more aggressive and difficult to treat," it adds.
Starting mammograms at 40 will save lives
Dr. Eleonora Teplinsky, the head of breast medical oncology at Valley Health System in Paramus, New Jersey, and a clinical assistant professor of medicine at Icahn School of Medicine at Mount Sinai acknowledged that the recommendation "is an extremely important step." But she noted that the guidance for screening starting at 40 was for every other year.
Teplinsky said annual screenings were even better, as recommended by the National Comprehensive Cancer Network and the American Society of Breast Surgeons. This is because the earlier cancer is detected, the better the outcomes are. And some breast cancers — such as HER2-positive cancer, which was what I had — tend to have more aggressive growth, so early detection is even more crucial. Time wasn't on my side.
She also said that the new recommendations were for women of "average risk" and that those with higher risk may need to start screening at earlier ages. This may require "supplemental modalities," such as breast ultrasounds and breast MRIs. These can help doctors take a closer look at breast tissue.
Dr. Anjali Malik, a board-certified, fellowship-trained breast-imaging radiologist in Washington, DC, told Insider: "We have long known that annual mammograms starting at 40 reduces the mortality from breast cancer by 40%."
She added that the Preventive Services Task Force's recommendation "will save the lives of so many."
I'm grateful for any updated guidance, but I think more could be done
As a two-time breast-cancer survivor, I'm grateful for any new recommendations that will save lives. Even though the American Cancer Society seemingly discourages self-breast exams and clinical ones for women with average risk who routinely get mammograms, I urge everyone with breasts to do monthly self-exams and bring any concerns to their doctors. Even as a now-flattie, I do a monthly self-chest exam.
Siteman Cancer Center says to look out for breast lumps or thickening; any changes in size, shape, or heaviness of one breast; nipple discharge or changes in appearance; tenderness, pain, or aching in one area of the breast; redness or dimpled skin; warmth; itching; nipple inversion; lymph-node enlargement; and more.
For the 50% of women with dense breast tissue, which makes cancer harder to detect on mammograms, should they also have an annual ultrasound?
The task force says "Black women are 40 percent more likely to die from breast cancer than White women" and "too often get aggressive cancers at young ages." What guidelines need to be in place for Black women? How do we better instruct and screen women with breast implants, since the Food Drug Administration says "between 22% and 83%" of 'visualizable breast tissue' can be obscured by breast implants"?
There are still many unanswered questions, and there's more that could be done to provide explicit guidance; this much seems clear to me. But this is a good first step, at least. We need to go out with the old and in with the new if we're going to help more people survive breast cancer.
Read the original article on Insider