Sharon Denise Allison-Ottey
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What's REALLY going on with Breast Cancer Screening Recommendations

No need for Mammograms before 50?
The Self Breast Exam is Useless?
What’s REALLY going on with Breast Cancer Screening Recommendations

A Candid Conversation with Breast Cancer Expert
Written by Sharon D. Allison-Ottey, MD (www.drsharononline.com)

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There has been UPROAR in the public, government and medical community regarding recent changes in recommendations specifically associated with women’s health from the United States Preventive Services Task Force (USPSTF). Women all over the country are asking what they should do. Are the recommendations correct? What about my specific risks? Will my insurance company pay for screenings? And many other questions are circulating in the heads and hearts of women.

The American Cancer Society's most recent estimates for breast cancer in the United States are for 2009:
  • 192,370 new cases of invasive breast cancer
  • 40,170 deaths from breast cancer

Breast cancer is the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer. The chance of a woman having invasive breast cancer some time during her life is a little less 1 in 8. The chance of dying from breast cancer is about 1 in 35. Breast cancer death rates have been going down. This is probably the result of finding the cancer earlier and better treatment. Right now there are more than 2½ million breast cancer survivors in the United States. (www.cancer.org).

Given these facts, many of physicians (surgeons, radiologists, oncologists and other specialties), other health professionals, and breast cancer research and advocacy groups are outraged by what is believed to be a move that may save money but cost lives. I cannot stress enough the need for you to have a discussion with your personal physician, understand your risks factors and to commit to taking care of your body. There have been updates from the USPSTF since their original recommendations, and you can learn more by visiting: www.ahrq.gov/clinic/uspstf/uspsbrca.htm.

I wanted to give you the best possible advice and interviewed an expert on breast health, Regina Hampton, MD. Dr. Regina Hampton is a highly regarded practitioner in the surgical management of benign and malignant breast disease in women of all ages. Dr. Hampton attended the Medical College of Pennsylvania (now Drexel University), in Philadelphia. She went on to complete a general surgery residency at Howard University Hospital. Dr. Hampton completed a two-year research oncology fellowship, researching CEA, a tumor marker in colon cancer, at the Georgetown University Lombardi Cancer Center. She is a board certified general surgeon who has focused her practice on breast health. She has been extensively interviewed by the media on this very controversial issue and gives a unique perspective. Visit Dr. Hampton’s website at www.signaturebreastcare.com and if you’re in the MD, DC or VA area and facing any challenge with your breast health, give her a call for consultation at 301.552.7805.

Dr. Sharon: What are your professional recommendations for breast cancer prevention?
Dr. Regina Hampton: We still do not have the absolute solution for preventing breast cancer but here are some recommendations:
-          Maintain healthy weight and exercise
-          Eat a low fat diet
-          Do not smoke
-          Monitor consumption of alcohol
-          Do not take hormone replacement therapy (HRT) for greater than 5 years

Things women can do for early detection and screening:
  • Perform monthly breast self exam (BSE) 7-10 days after the 1st day of the menstrual cycle
  • Get a baseline mammogram at age 35, then yearly mammograms at age 40
  • Get a clinical breast exam from a health care provider yearly
  • If there is a family history of breast cancer before the age of 45, then the women in that family should start screening 10-15 years earlier.

Dr. Sharon: In a nutshell, can you interpret the new recommendations in contrast to the previous recommendations?
Dr. Regina Hampton: The new recommendations are suggested by the USPSTF (are not in line with the current guidelines issued by the American Cancer Society (ACS).  Both are for women with average risk for breast cancer.

USPSTF:
1. Mammograms should be performed in women between ages 50-74, every 2 years
2.   Breast self exams should not be taught or encouraged
3.   There is no benefit to screening women over the age of 74

 ACS:
1. Mammograms should be performed yearly for women over the age of 40
2.  Clinical breast exam by health care provider every year
3.  Breast self exam monthly

Dr. Sharon:  What do you recommend for your patients and have the recent recommendations by USPTSF changed these recommendations?
Dr. Regina Hampton: I am continuing to follow the ACS recommendations.  I believe the USPSTF recommendations are not based on current data for young breast cancer patients.  Women under the age of 50 are at risk for breast cancer.  We know that African American women develop breast cancer at earlier ages than Caucasian women, so it is of utmost importance that we continue to screen them aggressively.  Some studies even recommend dropping the screening age for African American women to 32.

Dr. Sharon: What position have organizations that you respect and/or are a member of taken at this point?
Dr. Regina Hampton: I am a member of the American Society of Breast Surgeons and the American Society of Breast Disease who oppose the new recommendations.  I highly respect the American Cancer Society and the Susan G. Komen Foundation who also oppose the new recommendations.

Dr. Sharon: Do you have special recommendations for women of different ethnic groups (i.e. Caucasian, African American, Hispanics, etc...)?
Dr. Regina Hampton: My philosophy and teaching to my patients is that any woman with breasts is at risk for breast cancer.  If there is a family history, then screening should start at least 10 years prior to the youngest family member diagnosed.  African American women under the age of 50 have a biologically different and more aggressive cancer than Caucasian women.  It is important that African American women get the appropriate screening and notify a health provider when a mass if felt.  They must be persistent and advocate for their own health.

Dr. Sharon: What is your greatest concern/fear regarding the public's interpretation of the results?  Have you seen any reaction from your patients and your scheduling?
Dr. Regina Hampton: My concern is that we currently only screen 50% of women in the country.  There are still many women fearful of getting mammograms and performing BSE.  These recommendations will give them the excuse not to get a mammogram.  If we allow the USPSF recommendations to stand, the death rates will certainly increase because we will be finding cancers at a later stage.  This will reverse all of the hard work done up to now.

Dr. Sharon:  Any parting words for our readers on breast health?
Dr. Regina Hampton: Be an advocate for you own health.  Do not only get your mammogram, but make sure you follow up on the results (if you have not received a notice within 10 days, then call your physician).  If you are a young woman, who feels something abnormal in your breast, seek out a breast specialist who will get the appropriate breast imaging in order to make a diagnosis.  80% of the biopsies we perform will be noncancerous.  Perform BSE and get your mammograms.  If you doubt they are effective, then I’d be happy to introduce you to many of my personal patients who can tell you why they are survivors!Back