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| Clinical Breast Exam Photo © National Cancer Institute |
When the U.S. Preventive Services Task Force (USPSTF) released its new guidelines for breast screening in November, they included some remarks about the value of breast self-exams and clinical breast exams. The USPSTF said that women of any age should not be taught to do breast self-exams, but they did not forbid BSE for women or men. The USPSTF also said that clinical breast exams won't be required before screening mammograms, because CBE appears to add no benefit to the information gained from a mammogram.
Many of you wrote in comments about finding your own lump before the age of 50, which is the new age at which the USPSTF recommends starting screening mammography. You used breast self-exams and mammograms to find these problems, and probably saw a doctor as well, for your clinical exam. Good for you!
With health care reform still being hotly debated in the government, the nightly news, and around the dinner table, I am wondering how much early detection we may lose when we are given a new health care plan. In the last 30 years, several cancer types have been caught sooner, treatments have improved, and survival rates have climbed. Will this all be given away to save money? Or will the voice of the average person - folks like you who have been practicing early detection - be bypassed?
I'd love to hear from you about this. Would you give up doing your breast self-exams? Did having a clinical breast exam help you get a clear diagnosis and treatment (if you needed it) for breast cancer? How do you think the lack of these early screening tools would affect your health?
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If I didn’t do breast self exams, I’d probably be dead by now. The type of breast cancer that I have is IBC (Inflammatory Breast Cancer), which doesn’t usually present itself with a lump and doesn’t usually show up on a mammogram. It’s highly aggressive and very deadly if not diagnosed early. Checking your breasts can save your life. You need to learn the signs and symptoms of IBC because your own doctor may not be aware of this uncommon breast cancer. Look for a sudden increase in breast size, bruising, a rash, dimpling like the skin of an orange, inverted nipple, something that looks like a bug bite, itching or pain, or ANY change in your breast and get IBC ruled out. You can get information about IBC at http://www.EraseIBC.com. You may have to fight to get the treatment you need (a biopsy), but don’t be afraid to fight for it…it’s your life.
In my support group I hear stories every day of women who ended up being diagnosed as Stage IV because their doctors weren’t aware of IBC. When you’re diagnosed with IBC, you’re at least a Stage IIIB (cancer spread to lymph nodes). If it’s spread to other organs, you’re a Stage IV. There is no Stage V. My mission is to educate as much of the general population and the medical profession as I can in order to save lives.
One other sign/symptom that I failed to mention is swollen lymph nodes under the arm or above the collarbone.
I’ve just gone through the pros and cons of mammograms and rejected them. It was a difficult decision as unlike cervical cancer, this is a common cancer. (similar numbers to prostate cancer) We’re all programmed these days to “do something” to prevent these cancers or catch them early.
BUT if the test is unreliable (false positives and over-treatment), harmful, the cancer is rare or your risk profile is very low, sometimes it’s better to live well and respond to symptoms.
Our doctors don’t do routine breast exams, I’ve never had one. My Dr has believed for a long time that they don’t reduce the death rate from cancer but cause lots of nasty biopsies. Some doctors think biopsies may be a risk factor for breast cancer.
I read articles by Professor Michael Baum, UK breast cancer surgeon which were helpful…he helped set up BreastScreen, but now believes we need to stop and take a fresh look at the evidence, too many healthy women are being harmed.
I’d recommend to any woman thinking about CBE’s or mammograms to look at the Nordic Cochrane Institute website – they have the only unbiased account for the pros and cons of mammograms I could find online. I found it really helpful – they have conducted research into the real value of CBE’s as well.
Finally, there is an emerging school of thought that being “breast aware” is best…just taking note of the appearance of your breasts after showering and reporting any changes.
I’ve decided to do that…
Aside from having blood pressure checks and blood work every 2 years, I try to exercise, limit my intake of alcohol and adopt a healthy lifestyle. I grow my own vegies and herbs. My doctor mentioned faecal occult testing on my last visit. I said I’d have to do my research. I’m afraid I don’t trust doctors to give me the whole story with screening, it tends to be a promotion of the test with no critical assessment and that is just plain dangerous to your good health. I think in many cases screening is a bigger and more likely threat to our health than cancer.
I just sent this post to a bunch of my friends as I agree with most of what you’re saying here and the way you’ve presented it is awesome.