Recent trends in breast cancer detection have wavered. To perform breast self-exams, or not? To get mammograms, or not?
The worry about breast self-exams is that they may skew results into too many false-positive tests. Some who recommend fewer mammograms have suggested that over-screening leads to unnecessary invasive tests and undue anxiety. However, the 2011 Breast Cancer Symposium of the American Society of Clinical Oncology overwhelmingly supports these preventive measures. The American Cancer Society agrees.
"While there has been ongoing debate about when and how breast cancer screening should occur, this study validates that women who undergo regular mammography screening present at earlier stages and often require less aggressive treatment than those who do not," said Dr. Jamie Caughran, medical director of the Comprehensive Breast Center at the Lacks Cancer Center in Grand Rapids, MI.
Dr. Rosanne Newell, director of the Solomon Katz Breast Center at Sound Shore Medical Center in New Rochelle, Caughran, who helped lead the research team for a recent study on mammography said women age 40 and up should use both methods for detection. High-risk patients should seek advice from their doctors about the age for and frequency of tests.
In New York, experts predict 15,570 new cases of breast cancer to be diagnosed this year. According to the Centers for Disease Control, the female breast cancer incident rate in New York state was 122-124 per 1,000 in 2007, the most recent year available.
The Michigan study, completed this year with data from nearly 6,000 women with breast cancer, counters guidelines by the U.S. Preventative Services Task Force, which recommends generally that women get mammograms every two years beginning at age 50. The USPSTF notes that screenings should be determined on an individual basis.
Among other findings in the Michigan study:
- Breast cancer in women younger than 50 was more likely to be detected first by feel than by mammography. Of the women whose tumors were found by feel, 40 percent were younger than 50.
- Overall, 65 percent of the breast cancer cases were detected by mammography, while 30 percent were detected by feel and the other 5 percent by other methods.
- For women diagnosed with breast cancer before age 50, 49 percent of the cases were detected by mammogram. Of those, 18 percent were Stage 2, and 4 percent were Stage 3.
- For women diagnosed with breast cancer before age 50, 46 percent of the cases were detected by feel. Of those, 50 percent were Stage 2, and 17 percent were Stage 3.
- For women over 50, 81 percent of breast cancers are detected through mammography.
In 2011, ASCO predicts 230,480 new cases of breast cancer for women, 2,140 for men, and 57,650 non-invasive cases. About one in eight women will develop breast cancer, according to ASCO.
"Women of all ages presented with palpable tumors, highlighting the use of self-breast exam as an important public health measure," Caughran said.
Robin Perlmutter, of Briarcliff Manor, who works as a peer counselor at the Yorktown-based , said she feels lucky to have gone to her doctor's who found a lump in her breast 12 years ago and urged her to get a mammogram. A biopsy confirmed she had breast cancer and she was able to start her treatment at age 37.
"I was fortunate enough he felt something and immediately sent me to the mammogram," she said. "I never would have felt that."
Perlmutter said women are too busy and don't make time for themselves often enough, but women should pay attention to their bodies. She said she wants to encourage women to be diligent and go to their doctor's office for routine exams and follow ups.
"Until I worked here [at Support Connection], I thought breast cancer is breast cancer," she said. "But each woman's cancer is different."
Perlmutter said early diagnosis helps, but there is no correlation between early detection and survival. She has spoken to some women who had gotten treatment at a later stage of their cancer and have responded well to treatment. Perlmutter said she considers herself cancer free since July 2000, after her last chemo treatment.
"Just put yourself to the top of the list and don't forget yourself," she said. "Follow up on your appointments."