Yesterday, while getting my 3 and 4 year old ready for day care, I stopped to listen to a segment on Good Morning America about updates to breast cancer screening guidelines released by the US Preventative Task Force (USPTF). First, I’d like to thank Steve Jobs for making that moment even possible because both of my boys were happily playing on their iPads which allowed me to actually attend to this segment vs. run interference on an impending spilled sippy cup or being subjected to whiny Caillou. For that Steve…I’m eternally grateful.
Unfortunately the segment left ME wanting to throw a sippy cup and whine like Caillou because yet again women are hearing a message that the importance of proactive breast health is being questioned. Now I’m no researcher, I’m no breast surgeon, and I’m no economist.
But what I am is a breast cancer advocate, a young breast cancer survivor, and a woman whose early breast cancer diagnosis allowed her to have two beautiful baby boys AFTER breast cancer. So after, yet again, hearing that breast cancer screening guidelines are being softened, especially for young women, my blood began to boil and I had to remind myself to “calm my body down” just like Miss Leslie, the boys’ preschool teacher, tells them to do when they’re angry. “Use your words”, she says.
So, like a good adult should, I’m going to attempt to “use my words” to explain why I find these new guidelines so troubling. Here are a couple dangerous messages that I think women, especially young women, hear when studies like these are released.
Hey procrastinators…you’re in luck! Putting your mammogram off is OK!
I think perhaps the thing that angers me most about these types of studies is that women take away the sound byte, the cliff notes of it all. And with both the ACS guidelines released in October 2015 and the most recent ones released by the USPTF, the take away to me sounds like this: “If you want to put off your mammogram that’s ok.”
Well that’s not OK…not at all. Especially not when most women likely put off getting their mammogram in the first place.
When I turned 40, I remember reminding all of my friends to get their mammograms. You know, I’m the “Feel Your Boobies lady”, that’s my job right? And even with my ever-so-kind but persistent reminders I know plenty of my friends put off going for a year or even two. Not because they’re lazy, but because they are busy…you know, life just gets in the way. We’re moms, wives, caretakers and sometimes things we mean to do just get put on the back burner.
So with these new guidelines I worry that all of those 39 year olds out there, who were going to put off their mammogram until they were 41 or 42 anyway will now put them off until they’re 46 or 47 (if you follow the ACS guidelines) or hey, 51 or 52 (if you follow the USPTF guidelines).
Unacceptable. And using the stress of a false positive or the invasiveness of an unnecessary biopsy as the reason why mammograms are not suggested for the younger population is offensive, in my opinion. I think women can decide for themselves what tests they can withstand to definitively find out if they have cancer or not.
Stop “feeling your boobies” because it doesn’t matter. In fact, doctors shouldn’t even “feel your boobies” either!
Say wha? Yes these guidelines raise questions about the effectiveness of both breast self-exams (those performed ourselves) AND clinical breast exams (those performed by our doctors or medical professional). Seriously? These exams are free right? Yes, I believe so.
Now I do need to say this. Breast self-exams (BSE) are medically defined by following a specific process/procedure for examining your breasts. The definition of BSE suggests that there is a right and a wrong way of doing them. I don't really promote BSE's either. I’m actually a proponent of what is defined as “breast awareness”, which takes a looser approach to examining your breasts. Breast awareness focuses less on HOW you examine your breasts; and more on the idea of becoming familiar with your body generally. "Breast awareness" suggests that knowing your breasts doesn’t necessarily mean you have to follow specific steps (which is what breast self-exam suggests).
I agree with this completely. In fact, when I speak to young women many of them state the fear of doing it incorrectly is why they don't do it at all. I wasn’t doing a breast self-exam when I found my lump in my early 30's…i just noticed the lump during the course of my daily routine. This is what Feel Your Boobies stands for and is also what the ACS guidelines suggest too.
What I disagree with is that the guidelines suggest doctors should no longer do clinical breast exams during our annual gynecological check-ups. And also the fact that most women in the general public don't know the difference between "breast awareness" and "breast self-exams" - to them it’s the same. So what they hear is that feeling your breasts is not important.
Based on my experience in speaking to many many women, they are shy about touching their own body. And they are also shy about bringing up issues to their doctor. So removing a doctor's examination of our breasts from our annual check-ups removes one more opportunity for there to be an open dialogue between a woman and her doctor about proactive breast health. And stating that breast self-exams are not necessary means that many women will just stop feeling their bodies (or never start!).
So while the articles and commentators I hear on TV translating these new guidelines continue to emphasize how important an open dialogue is between a woman and her doctor, their suggestions to change these things only serve to decrease the opportunity for that dialogue to occur.
Case in point. Last month I FINALLY scheduled a basic physical with my general practitioner. I honestly cannot remember the last time I went to get a normal physical. Not because I was putting it off, but because I have been under acute care for the past 10 years or so. First for my breast cancer diagnosis at age 33, then for being a high risk pregnancy (delivered my boys at age 40 and 42). So after hearing all of these new guidelines I vowed to myself that I would REQUEST that the doctor do a breast exam on me while I was in the office. I've urged other women to do the same.
But guess what? I FORGOT. Me, the Feel Your Boobies lady, the one who’s ranting about all of this…yes, me…I FORGOT.
I can only imagine how many other women who aren’t entrenched in the breast cancer space won’t request that their doctor performs a clinical breast exam.
Ok so I’m stepping off of my soap box now.
So enough with my sarcasm. In all seriousness, and in an attempt to objectively review these guidelines even with my bias perspective given my personal history, I reached out to a few of my friends who are breast surgeons to get the FACTS. To have them really tell me like it is, even if it differed from my personal opinion and was something I didn’t want to hear.
Well it seems that the ones I spoke to felt the same way I do...because they see young faces all the time in their offices and they KNOW mammograms and breast exams matter.
Here’s a link to Dr. Beth DuPree’s “Buzz Blog” that does a great job highlighting the facts.
So please, don’t stop “feeling your boobies” and don’t stop getting your mammograms!
For me, all of these changes point to one thing. Education is even more important than it was before. That’s what Feel Your Boobies has always believed, but now that a whole new group of young women may be eliminated from receiving screening mammograms or being examined by their doctors, then knowing our bodies may be our best line of defense against breast cancer. It’s not a perfect way, and yes, we will find lumps that aren’t cancer. But right now, it’s the best way to be proactive with your breast health.
And for the record, I didn’t throw any sippy cups while writing this and and I did my absolute best not to whine either. I only hope that I “used my words” in a productive way to express my frustrations. Thank you Miss Leslie for reminding me that all I need to know comes in the form of pre-school child development strategies.