Todd Hartley: How often do you get a breast self-exam, and how often should you get your routine mammograms? Since the U.S. Preventive Services task force’s early detection against breast cancer recommendations came out, those are the two biggest questions in women’s health.
Hi, this is Todd Hartley for EmpowHer where it’s our job to clear up the confusion and present all credible sides so you can make the most informed health decisions possible.
Now fortunately there are two members of EmpowHer’s Medical Advisory Board that are perfectly placed to provide you the most credible breast health information possible – Dr. Bernadette Melnyk, who sits on the U.S. Preventative Services Task Force that made the government’s breaking news recommendation, and on the other side of the issue, Dr. Jay Harness, the President of Breast Surgeons International.
Now here is what we know: The U.S. Preventative Services Task Force Early Detection Against Breast Cancer recommendation said, “Women should start getting mammograms at 50; get a new one every two years, and breast self-exams – well they do more harm than good.”
Now here’s the controversy: This recommendation contradicts conventional wisdom, from leading experts like Dr. Jay Harness, who you will hear from in a moment, and the American Cancer Society, which says, “Women should start at age 40 having a screening mammogram every year and breast self-exam should start in their twenties.”
So to get started, clearing up the confusion we reached out to task force member Dr. Bernadette Melnyk, a nurse practitioner and seasoned researcher.
Dean Melnyk, is the U.S. Preventative Services Task Force saying that women shouldn’t get mammograms until they are 50 years old?
Dr. Bernadette Melnyk: That is not what we are saying. Our most recent recommendation, Todd, is not against, not a recommendation against screening women in their 40s. It is a recommendation against routine screenings starting at age 40. What we need to understand, though, is it is imperative that women talk to their provider, their physician or their nurse practitioner about what their risks are for breast cancer.
Primary care providers are going to do a thorough history on that woman if there is a risk for breast cancer. For instance, if a woman has breast cancer that runs in her family, her sister, her mother, her blood relative – that woman would be at risk and would deserve to have it screened. What we are saying is not to start routine screening at age 40 for any woman who walks in the door of your office.
Todd Hartley: What about breast self-exams? Now the report makes women feel like they shouldn’t be taught them and self-exams do more harm than good, can you clear this up for us?
Dr. Bernadette Melnyk: Yeah, I think, you know, that latest evidence again does not recommend the teaching of self-breast exam because of the associated potential for harm. Again, self-positives, unnecessary biopsies, anxiety that it does cause women. We also have insufficient evidence at this point in time to make a recommendation for or against continuing clinical breast examination by healthcare providers.
Todd Hartley: For the extended interview with Dr. Melnyk, just click on the Dr. Melnyk Interview link on the top of this page. To provide the other side of this issue we then spoke with Dr. Jay Harness, President of Breast Surgeons International and the former President of the American Society of Breast Surgeons.
Dr. Harness, do you support the U.S. Preventative Services Task Force’s recommendation that routine mammograms should not start until a woman reaches 50 years old instead of 40 years old?
Dr. Jay Harness: I do not and I have been inundated with emails since the task force made its recommendation. I have been receiving blast emails from organizations like the American Society of Breast Disease, the American Society of Breast Surgeons and other groups who point out that we have a body, a wealth of information and clinical trials that support the current recommendations for starting our screening efforts in the United States at age 40.
Todd Hartley: Do breast self-exams do more harm than good and should we stop teaching women how to perform them?
Dr. Jay Harness: Once again I think the answer is absolutely not. The view of myself and I think some of the national organizations that I am involved with is that these current recommendations can be looked upon as a major step backwards. If you look at the falling mortality from breast cancer in the United States, certainly over the past decade or more, we are finally seeing the effect of breast cancer screening efforts that began in the mid 1970s and carried forward. To think that we would stop teaching breast self-examination and that women would show up with very large masses in their breasts that are cancerous, is a preposterous sort of proposal.
Todd Hartley: In order to give you a more complete picture EmpowHer didn’t stop there. We then checked in with Deb Weintraub, the Director of Mission Programs for the Los Angeles affiliate of the Susan G. Komen for the Cure.