The Truth About Your Breasts: Current Science on Screening

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The Truth About Your Breasts: Current Science on Screening

Post by roxybeast » January 10th, 2010, 4:23 pm

<center>The Truth About Your Breasts:
The Current Science on Breast Cancer Screening

(Medical/Scientific information compiled by Beth Isbell, Jan. 2010)</center>
American Cancer Society current guidelines:

• Women age 40 and older should have a screening mammogram every year, and should continue to do so for as long as they are in good health.

• Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional, preferably every 3 years. After age 40, women should have a breast exam by a health professional every year.

• Breast self-exam (BSE) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to a health professional right away.

• Women at high risk (about 20% or greater lifetime risk based on family history or history of prior treatment with radiation) should get an MRI (magnetic resonance imaging) and a mammogram every year beginning at age 30 (see below).

There is not enough evidence to recommend for or against the use of MRI for women at moderately increased risk (15% to 20% lifetime risk) based on family history or other risk factors. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

Women at high risk include those who:

• have a known BRCA1 or BRCA2 gene mutation
• have a first-degree relative (mother, father, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
• have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on a family history that includes both her mother's and father's side
• had radiation therapy to the chest when they were between the ages of 10 and 30 years
• have a genetic disease such as Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives

Women at moderately increased risk include those who:

• have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history (see below)
• have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
have extremely dense breasts or unevenly dense breasts when viewed by mammograms

If MRI is used, it should be in addition to, not instead of, a screening mammogram. This is because while an MRI is more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect.

American Cancer Society discussing concerns regarding radiation risks of mammography:

"The modern mammography machine uses low radiation doses to produce breast x-rays that are high in image quality. Older mammography units delivered higher doses, and led to concerns about radiation risks. These older machines are no longer used. ... Strict guidelines ensure that mammography equipment is safe and uses the lowest dose of radiation possible. Many people are concerned about the exposure to x-rays, but the level of radiation from mammography today does not significantly increase the breast cancer risk for a woman who gets regular mammograms. ... To put it another way, the dose of radiation that she gets during a screening mammogram is about the same amount of radiation from her natural surroundings (background radiation) she would average over about 3 months."

Dr. Mehmet Oz discussing the recent Unites States Preventive Screening Task Force was recommending women without risk factors begin mammograms at age 50 instead of 40:

"In general, discouragement against mammography is the wrong message for anyone to take from these findings. ... Mammograms do not cure or prevent cancer; they just find it. So do not forget the things YOU can do to help prevent breast cancer. For example: lose weight if you're overweight, keep it under two alcoholic drinks a day, and take 1000 units/day of Vitamin D."

Finally, while there is one book out suggesting that wearing a bra may increase your risk of breast cancer, the medical and scientific community has uniformly rejected these findings and soundly criticized the extremely poor methodology used by its authors:

Wikipedia: "Dressed to Kill is a book by Sydney Ross Singer and Soma Grismaijer that proposes a link between bras and breast cancer. According to the authors, the restrictive nature of a brassiere inhibits the lymphatic system. The book's claim that bras cause breast cancer has been dismissed by the medical and scientific communities; the National Cancer Institute,[1] the American Cancer Society,[2] and the National Institutes of Health[3] have all concluded that there is no link between bra use and breast cancer. ... Medical and scientific bodies which have examined the book's claims have generally dismissed them on the basis of poor methodology, lack of supporting evidence, and Singer and Grismaijer's failure to consider alternate explanations besides bra use for their findings.
One specific critique of the their book by Martha Molete of the Cancer Association of South Africa argues that numerous aspects of the book's claims are scientifically unsubstantiated or unproven, citing:
• Lack of controlled epidemiological data correlating bra-wearing with the risk for breast cancer
• Lack of proof that the pressure exerted by a bra reduces the flow of lymph
• Lack of proof that lymph contains carcinogens
• Lack of proof that there are carcinogens in the human body that can induce breast cancer
• Existence of published data correlating obesity with post-menopausal breast cancer
None of the authors' surveys have attempted to account for any of the well-known epidemiological risk factors for breast cancer, such as number of full-term pregnancies, age at first pregnancy, obesity, Western pattern diet, or use of medications such as hormone replacement therapy. Per Molete, "the authors' statistical treatment of their obtained data appears to be flawed. They do not include the data or a detailed description of the statistical treatment of the data. The two groups, i.e. those wearing bras and those that did not, were not controlled for many other factors influencing the risk of breast cancer."[14] A survey of the MEDLINE/PubMed database revealed no published scientific studies supporting a link between bra wearing and breast cancer risk.[14] Furthermore, no scientific publications were found which were authored by Singer or Grismaijer.[14] ... Other medical and scientific bodies uniformly reject the book's claims about bras and breast cancer:
The National Cancer Institute (US) states that bras have not been shown to increase a woman's risk of breast cancer.[2]
Breastcancer.org specifically answers this question, relating to bras and how breasts are touched.[1]
The American Cancer Society states, "There are no scientifically valid studies that show wearing bras of any type causes breast cancer."[2]
The U.S. National Institutes of Health states, "Breast implants, using antiperspirants, and wearing underwire bras do not raise your risk for breast cancer."[3]
In 2000, as a follow-up to misreporting of a UK study, British health professionals and "Cancer charities" stated that bras cause no increase in breast cancer risk. [16][17]"

<center>Additional resources:</center>
The following related information may also be helpful to you. These materials may be ordered from the American Cancer Society's toll-free number, 1-800-227-2345 or visit http://www.cancer.org

After Diagnosis: A Guide for Patients and Families (also available in Spanish)
Breast Cancer (also available in Spanish)
Breast Cancer Dictionary (also available in Spanish)
Breast Cancer Early Detection (also available in Spanish)
Breast Cancer in Men
Inflammatory Breast Cancer
Breast Reconstruction After Mastectomy (also available in Spanish)
For Women Facing a Breast Biopsy (also available in Spanish)
Non-cancerous Breast Conditions (also available in Spanish)
Talking with Your Doctor (also available in Spanish)


<center>National organizations and Web sites:</center>
In addition to the American Cancer Society, other sources of information and support include:

• National Cancer Institute
Toll-free number: 1-800-422-6237 (1-800-4-CANCER)
TYY: 1-800-332-8615
Web site: http://www.cancer.gov
Offers current information about breast cancer screening, diagnosis, and treatment as well as information on other types of cancer

• Susan G. Komen for the Cure
Toll-free number: 1-877-465-6636
Web site: http://www.komen.org
Offers information on breast health and breast cancer; tools, including videos and quizzes. Some written materials in Spanish, Arabic, Chinese, Vietnamese, Russian, and Korean

• National Breast Cancer Foundation
2600 Network Blvd., Suite 300
Frisco, Texas 75034
Web Site: http://www.nationalbreastcancer.org/
Offers information on breast health and breast cancer, including information diagnosis, treatments, and support groups

• Breast Cancer Network of Strength
Toll-free number: 1-800-221-2141,
Toll-free number for Spanish: 1-800-986-9505
Web site: http://www.networkofstrength.org
Patients and survivors may be matched with someone who has had the same diagnosis and is the same age. Partners of breast cancer patients may also get support from others

• Centers for Disease Control and Prevention (CDC)
Toll-free number: 1-800-232-4636 (1-800-CDC-INFO)
Web site: http://www.cdc.gov
To find out more about the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides breast and cervical cancer early detection testing for women without health insurance for free or at very little cost

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