I’ve found myself only mentioning breast self-examinations during either the month of October, when all of the other media outlets push their pink agenda (which normally only lasts for the first couple of weeks) or when my cancer free anniversary comes around (June 1, 2016 will be four friggin’ years!) But due to, yet again, having several women – all under the age of 40, mothers to adorable children and dear friends of mine – be diagnosed with breast cancer very recently, I’ve felt the need to push my own agenda during these ‘off’ months.
Before I write my opinion on this, know that I’m a Stage3b breast cancer survivor. Due to the amount of cancer history in my family, I was lucky enough to have my GYN insist that I start mammograms when I turned 36 despite what the ‘recommendations’ suggested. AND I was even luckier to have found my extremely aggressive tumor (which turned out to be 15. Yep, that’s plural) by doing a breast self-examination (BSE), at the age of 36 before I even went in for that coincidental suggested mammogram. AND I had a breast surgeon who had the balls enough to demand that I have a Pet Scan prior to any surgery or treatment to ensure that there was no cancer present anywhere else in my body.
I admit, I am one of the lucky ones, whose stars magically aligned and am now alive for it. So when the U.S. Preventative Services Task Force released an update this past January to their recommendations regarding Breast Cancer Screening, I became livid. First of all, who the hell is this USPSTF? And second, who the hell listens to them? To answer my own questions……
“The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine formed back in 1984. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. All recommendations are published on the Task Force’s Web site and/or in a peer-reviewed journal. It is made up of 16 volunteer members who are nationally recognized experts in prevention, evidence-based medicine, and primary care. Their fields of practice and expertise include behavioral health, family medicine, geriatrics, internal medicine, pediatrics, obstetrics and gynecology, and nursing. Task Force members serve 4-year terms. Members are screened to ensure that they have no substantial conflicts of interest that could impair the scientific integrity of the Task Force’s work.” To read more on who the Task Force is click HERE. And as far as who listens to them? Well, apparently everyone. Your doctor, the media, the old lady on the corner for all you know.
So when I hear ‘guidelines’ being changed (which to be honest has always seemed to me to have more to do with the cost to insurance companies than the safety of the patient), I literally want to rip someone’s throat out. But I soon found out, their guidelines haven’t changed. They’ve just been repeating their same advice on BSE since 2009, and not providing any substantial research to prove differently. Even though there have been changes to the Task Force’s views on mammograms as early as January 2016 (click HERE), there has been no change in over seven years to their recommendations on BSE. In 2009, the Task Force recommended AGAINST teaching BSE, saying that “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Furthermore, they say that the evidence of clinical breast examinations (CBE) is inadequate.” Since performing a BSE saved my life (thus I know the benefit), I have been searching for the ‘harm’ that they’ve yet to provide in detail. The only statement I could find from the Task Force was that, “The potential harms are thought to be small but include false-positive test results, which lead to anxiety and breast cancer worry, as well as repeated visits and unwarranted imaging and biopsies.” That’s it. Basically, no need to waste your doctor and insurance providers time and resources, just because you think you know your own body.
I decided to see what other institutions thought. The National Cancer Institute (www.Cancer.gov) says that even though monthly BSEs are promoted there is no solid evidence that they are effective in reducing breast cancer mortality. Their research? “The only large, well-conducted, randomized clinical trial of BSE randomly assigned 266,064 women factory workers in Shanghai to receive either BSE instruction with reinforcement and encouragement, or instruction on the prevention of lower back pain. Neither group received any other breast cancer screening.” Seriously. Their finding? After 10 years of follow-up, both groups had nearly the same number of breast cancer deaths, 135 and 131 respectively, and women in the instruction group received more breast biopsies and diagnosed benign lesions than the other group. (for their complete findings click HERE.) Again I ask, what harm is there? That we, as women, shouldn’t worry our little heads? The idea of us feeling our breasts may lead to mental anxiety? Or worse, a visit to the doctor? A demand for a test? Finding something there that isn’t deadly, but still, in fact, is there?
Finding any other research is limited. From Leningrad to the UK, they say that women who performed BSEs had more biopsies, doctor visits and such with no improvements in breast cancer mortality. Only Canada, dear sweet Canada….”Women who examined their breasts visually, used their finger pads for palpation, and used their three middle fingers had a lower breast cancer mortality rates.” So is everyone else just doing it wrong?
Breast cancer deaths are preventable because of 2 things: early screenings and physical exams – PERIOD! And to make an overall change or a blanket statement that is to relate to each and every individual is assinine and ignorant. I say – INSIST THAT YOUR DOCTOR GETS YOUR SCREENING APPROVED, pressure your physician to do a clinical breast examination. And most importantly, know your body by doing your own breast self-examination periodically. You are the client and product. It is your life. Your decisions, your choice! #badrightbreast #feelyourself #breastselfexam