Just when we think we’ve got it down, the experts change the rules. Have mammograms after age 40, we were told. Check your breasts every month. These days, the messages seem mixed. New research findings and recommendations appear — from an assortment of sources — on a regular basis, particularly during October, which is National Breast Health Awareness Month. How can we make sense of it all?
We spoke to two professionals in the field of women’s health who gave us the lowdown on today’s recommendations for better breast health.
While the American Cancer Society recommends mammograms beginning at age 40, the U.S. Preventive Services Task Force revised its screening recommendations in 2009. Previously, the task force concurred with the American Cancer Society; today, it recommends biennial mammograms for women ages 50 to 74.
“For women in their 40s, mammography does save lives, though the degree of benefit is not as great as for older women,” says Mary Laya, Ph.D., associate professor at the University of Washington School of Medicine. “This benefit comes at a cost: There can be a high rate of the need for additional mammograms, ultrasounds and even biopsies. After weighing the pros and cons, some women are choosing to opt out of early testing.”
Confused? That’s why experts suggest women talk to their doctors about whether or not they should have early screenings.
Still have those pamphlets that instruct you on how to search for lumps in your breast? Professionals today talk about breast health awareness, not breast self-exams. Kathleen Errico, Ph.D., nurse practitioner at the UW Medical Center, says that studies have not shown that performing breast self-exams help reduce the number of deaths from breast cancer. She encourages women to be aware of the “look and feel” of their breasts so that they can recognize changes that warrant a clinical breast exam or mammogram.
Laya agrees. “Breast self-exam increases discovery of benign lumps and doesn’t prevent death from breast cancer,” she says. “We do want women to remain attentive to any changes in her breasts. This means being aware of what is normal for you.”
For women with a family history of breast or ovarian cancer, there may be a benefit to genetic testing for BRCA gene mutations. Since mutations in the BRCA gene are one of many potential genetic causes of predisposition to breast cancer, the testing helps to identify gene mutations and assess personal risk for breast and ovarian cancer.
According to the National Cancer Institute, a woman who has inherited a harmful mutation in the BRCA1 or BRCA2 gene is about five times more likely to develop breast cancer than a woman who does not have the mutation. Errico states that age and onset of breast cancer in family members are the main considerations for testing.
Laya and Errico agree that women with a family history of breast cancer are at a higher risk for the disease. But Laya says, “Since most cancers occur in women without any ‘risk factors,’ we are all at risk, particularly as we age.”
What else can women do to stay healthy? Vigorous regular exercise, weight control, and limiting alcohol intake and exposure to some forms of post-menopausal hormones all can reduce the risk of getting breast cancer, says Laya.
Sharyln Gehrs is a Seattle-based freelance writer and editor.
Breast health awareness
Breast health awareness means knowing your “normal” and being aware of unusual changes. Here are six ways to build breast health awareness:
1. Know your risks. Talk to your family to learn about your family health history, and talk to your health care provider about your personal risk of breast cancer.
2. Know what is normal for you. Breasts are naturally lumpy as a result of age, glandular changes or your monthly cycle. Get to know your “normal” so that you can recognize changes when they occur.
3. Know what changes to look for. Look and feel your breasts, chest, and armpits. A thickening inside the breast, change in size or shape, swelling or redness of the breast, or dimpling of the skin are all signs you should look for.
4. Report any changes to your doctor. Not all lumps are cancerous and could be benign cysts or overgrowth of tissue, but make an appointment when you notice a change.
5. Be sure to attend recommended screenings. Regardless of the various recommendations around (screenings in your 40s vs. 50s, self-exams vs. breast awareness), consult with your doctor about the timing of your screenings based on your age and health risks.
6. Make healthy lifestyle choices. Staying at a healthy weight, getting regular exercise, limiting alcohol intake and focusing on good nutrition will help improve more than just your breast health.