Breast Screening Recommendations
This past November I was watching the morning news when I heard about new breast screening recommendations by the U.S. Preventive Services Task Force. I was horrified! The U.S. Preventive Services Task Force recommendations on screening mammography and self breast exams are not supported by evidence-based studies. The American Society of Breast Disease (a well respected group of breast specialists to which I belong) responded to the government’s new guidelines with the following:
The new U.S. Preventive Services Task Force’s recommendations on screening mammography, clinical breast exam, and self-examination conflict with the facts. There has been no new evidence to justify this questionable change in breast cancer screening guidelines.
The American Society of Breast Disease continues to recommend annual mammography for all women beginning at age 40. This position is based on long-standing, evidence-based studies which document that mammography saves lives through early detection.
The fact that only 50% of American women over age 40 have had a mammogram in the past year indicates that women need to be further encouraged rather than discouraged from obtaining this simple, non-invasive test. At a time of limited healthcare resources, prevention and early detection continue to be the most cost-effective means to control the economic and human burden of breast cancer. Although it is not perfect, mammography is the best screening tool we have, in terms of overall accuracy, cost, and practicality.
Forty years of research have yielded progressively convincing evidence of the benefits of screening mammography. Long-term follow-up of randomized controlled population-based screening trials – the gold standard in medical research – prove that mammography can reduce breast cancer mortality as much as 32% among women ages 40 to 70 years at entry into screening. Some recent studies from Sweden have found that mammography can lower breast cancer deaths by nearly 50%.
As dedicated breast specialists, we agree with the multiple studies that document a reduction in breast cancer deaths due to early detection of breast cancer through regular screening. In contrast to the USPSTF recommendation, the American Society of Breast Disease continues to encourage monthly breast self-examination as an integral part of every woman’s health routine, along with an annual clinical breast examination by a trained healthcare professional.
For most women, predicting breast cancer risk on the basis of possible risk factors can be unreliable. Fully 70% of all women diagnosed with breast cancer had no known risk before the time of diagnosis.
The current flurry of media-hyped recommendations will only serve to confuse the public. To advise women age 40 and older to skip annual screening because they have no family history of the disease is imprudent, irresponsible, and places their lives at unnecessary jeopardy.
Executive Committee: Gail Lebovic, MD is a Dallas-based oncoplastic breast surgeon and Society president; Stephen A Feig, MD is a breast imager at University of California, Irvince, and president-elect; Julio A Ibarra, MD is a pathologist at MemorialCare Hospital, Fountain Valley, California, and Society past president; Robert W. Carlson, MD is a medical oncologist at Stanford University and Society secretary/treasurer.
I hope this statement from a respected group of breast specialists helps to clear up any confusion about screening breast imaging and examinations.
If you’re 40 – start getting your mammograms!!
Pearls Of Wisdom
In my first blog in 2010, I am once again turning my attention to the very important topic of survivorship. Although I did not get any survivorship stories from my bloggers out there in “blog land,” I went on my own search for them because I know there is great strength in the telling of one’s story and the effect it has on another survivor could be profound and enlightening. Survivorship remains an important concept in cancer care because after all it is the aim of early diagnosis and treatment – improved prognosis for survival. I wanted to know 1) the survivor’s diagnosis and date of diagnosis; 2) what important lesson was learned along the journey; and 3) what pearls of wisdom would you share with patients, who are newly-diagnosed with cancer. Here are a couple of stories from survivors I interviewed:
Maria said, “I was diagnosed in 1998 with Stage One Breast cancer and chose to have mastectomy to be sure of clear margins. Along the way, I learnt that when you are hit with challenges in your health, you can find strength in everyone around you. My pearls of wisdom are that one must sort through one’s life and the things that are important and to overcome those hurdles of fear, denial, anger, depression, acceptance in order to move forward. Make everyday of your life count because life is too short not to enjoy it.”
Vickey indicated she was diagnosed with two different cancers, in 1981 with squamous cell carcinoma of the vulva and in 1992 with breast cancer. She went on to say that along the way she learnt the value of having close family and friends to accompany her to the doctors and take notes. “I gathered the information and opinions from professionals, not rumors, and then decided for myself about what was best for me. My pearls of wisdom are to take time to make your own decisions about your treatment and survivorship – the cancer did not occur overnight.”
I thank the survivors for their stories because often we hear the word “cancer” and we don’t always equate it with survivorship. So as we begin the 2010, I want to challenge you to think about life and how we can make the most of our lives as Maria said. I hope you all had a wonderful Hanukkah or Christmas and for those of you still celebrating Kwanzaa, have a wonderful Kwanzaa celebration. I wish you all a Happy New Year. Be safe and come back with more stories to celebrate life.
2009 Recap
How quickly this year has passed! It is hard for us to believe that this is the last blog post for our first year on the blogging circuit! We have enjoyed bringing this new venue of information and communication to you – our cancer center patients and interested community – and we hope that you have found it to be valuable too!.
It has been quite a busy and productive year for us at Holy Cross and the Bienes Cancer Center. We have continued to grow – both in terms of patient volume and size of professional staff. During 2009 we added new subspecialties and sub-specialists to our team including colorectal surgeons – Drs. Lescher, Basu and Schochet and added a new Hematologist/Oncologist Dr. David Drew who joined us in November from the National Cancer Institute. We added new technologies in our radiation oncology department including a new ultrasound based tumor localization system and a brand new linear accelerator with IGRT (Image-guided radiation therapy) and stereotactic radiosurgery capabilities. There is no cancer center in South Florida that has more technology than we do now! And we have maintained our high touch service along with the spirituality and faith based approach that we do with everything at Holy Cross. We continued to develop our disease specific focus for our physicians so that we have dedicated teams of physicians now who focus their practices on breast cancer, prostate cancer, gastrointestinal cancers, lung cancers and colorectal cancers. This specialization is allowing us to be the true leaders in our field that patients deserve and need.
Finally we have significantly expanded our clinical research program – opening the first community hospital based phase 1 clinical trials for cancer in South Florida. We are truly excited to be able to offer these new options to patients who have exhausted all other treatments.
Thank you for participating with us on our journey. 2010 promises to be even more exciting!
Board Certified Chaplains
Recently I attended a meeting in which I listed “Board Certified Chaplain” as part of my credentials. “What’s that?” I was asked, “I’ve never heard of it.” With the thought that there may be others who also have “never heard of it,” I’d like to describe my own path toward professional chaplaincy:
During a period in my life when I was an ordained deacon and chairperson of the diaconate of my Baptist church, as well as a member of a mission group in the center of Washington, D.C., I became aware of a deepening desire for spiritual growth. I was led directly to a Quaker seminary, the Earlham School of Religion in Richmond, Indiana, where I earned a Master of Divinity degree. As part of that degree, I did a fascinating and eye-opening Clinical Pastoral Education (CPE) internship at the National Institutes of Health (NIH) in Bethesda, Maryland. Following seminary, I began working at NIH and continued my CPE training, even as I was ordained to pastoral ministry. After finishing the four required units of CPE, I went through the chaplaincy-endorsing process of my faith group, the American Baptist Churches—USA. Only after a year’s professional experience could I begin the rigorous process of national accreditation through the Association of Professional Chaplains. Now, for public recognition, my title reads: Rev. (my ordination) Joanne Afshar, M.Div. (my degree) B.C.C. (Board Certified Chaplain).
God gives the gifts to fulfill God’s calling to ministry; study and training hone understanding and skills!
“Thanks be to God for God’s indescribable gift!” (2 Corinthians 9:15).
About the Center
The Michael & Dianne Bienes Comprehensive Cancer Center in Fort Lauderdale, Florida is the Cancer Care Leader in Broward County. Dedicated to providing patients with precise diagnosis, the latest and most advanced treatment and aftercare options, we offer a multidisciplinary approach to care, a compassionate and spiritual healing environment, and an affiliation with the National Cancer Institute.
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