The United States Preventive Screening Task Force issues new breast cancer screening guidelines
In the November of 2009 issue of the Annals of Internal Medicine, The United States Preventive Screening Task Force (USPSTF) issued new guidelines for breast cancer screenings that sent ripples throughout the world of woman’s health and woman’s health advocacy. The task force now recommends against routine mammography screening for women before age 50 years and suggests that screening end at age 74 years. Several organizations including the American Cancer Society and the American College of Radiology criticized the document and have stated that they will continue to recommend breast cancer screening according to the old guidelines. However, many other organizations including The National Breast Cancer Coalition and The National Women’s Health Network have embraced the new recommendations. A particular area of controversy lies in the USPSTF’s recommendation that women no longer be taught how to do breast self examinations. According to the USPSTF, adequate evidence suggests that teaching self-examination is not associated with a decrease in breast cancer mortality rates. As a result, the task force recommends against teaching breast self-examination (BSE). However, many women balked at this particular point in the recommendations, especially those women who have found breast lumps on self examination. Personally speaking, I can’t see the harm in women knowing how to perform breast self examinations. As such, I offer instructions here. Use them-or not- as you see fit.
Breast self examination is easy. Just follow these simple steps:
1. Do breast self-exams every month, the same time each month. Perform the exams one to two days after you complete your menstrual cycle, or if you are post-menopausal, on the same date (such as your birthdate) each month.
2. Remove all your clothes from the waist up.
3. Look at your breast in the mirror, noting the size, shape and color. Note any discolorations, dimpling of the skin or protrusions, or changes in the nipples. Raise your arms above your head and look again. Press your fists to your hips and look again. Bend over at the waist and look at your breasts in the mirror, again looking for discolorations, skin dimples or protrusions and changes in the nipple.
4. Either standing or lying down, place one hand behind your head. Using the other hand and keeping the fingers flat, apply gently pressure to your breast feeling for any lumps. You may feel in an up and down pattern, an across the chest pattern or a circular pattern. Be sure to feel under your arm and as far medially as the breastbone. Gently squeeze the nipple and look for any discharge. 5. Switch hand positions and do the other side.
Have a healthcare provider evaluate any suspicious findings immediately.