New guidelines add to women’s confusion.
Hang on, now. Before I get into a hospital gown and jam my naked girls into the medical equivalent of a panini maker, let me get a few things straight.
Every other year with the mammogram? You sure? Because the last time I heard from you folks at the American Cancer Society (ACS), I was advised to go annually, starting at age 40 — not 45, which is what was recommended the other day.
And then there’s the U.S. Preventive Services Task Force, which just said that most women don’t need to start having the screening until the age of 50.
Adding to the confusion, The American Congress of Obstetricians and Gynecologists, which said women need to start lining up for the old stand-and-squish starting at age 40.
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Three organizations, three different recommendations. And our health — literally — in their hands.
Having breasts in America is a little like having two teenagers who will only communicate with you via text. You want everyone to be safe and healthy. But you can’t get a complete or straight answer from anyone. And the answers you do get change all the time.
“Oh, God. Everybody’s going crazy here,” said Anna Gottlieb, the executive director of Gilda’s Club, a nonprofit that supports cancer patients and their families. They track cancer-prevention advisories daily, and even they’re confused.
“It’s like drinking red wine,” Gottlieb said. “Are you supposed to, or not supposed to? And if so, how much?”
She introduced me to Heike Malakoff, the founder of a nonprofit called CanCan, which educates women about breast health.
CanCan (previously known as “Check Your Boobies”) does some 200 educational workshops a year at college campuses, low-income housing developments, homeless shelters and even private parties.
“Our mission is to make people feel more in control and less in fear,” she said, then looked down at the newspaper with the recommendations on the front page. “And this doesn’t do that at all.
“The ACS said physicians shouldn’t do breast exams at the OB/GYN,” she said. “It’s crazy. It’s just noise. I could not disagree with it more.”
Not only are the mixed messages from the medical community confusing, they’re dangerous in that they give women a false sense of safety.
Malakoff herself was diagnosed with breast cancer at 34 — well before any of the recommended ages for starting mammograms.
She found the lump herself, while breast-feeding her twin sons. (She had noticed a smaller lump 18 months before, while nursing her daughter, but it was benign.) Under the new guidelines, she wouldn’t have even gone in.
One CanCan colleague — also younger than the age guidelines — only had a screening because her employer, Microsoft, had a mammography van visit the Redmond campus. The exam found ductal carcinoma in several locations, and the woman had it removed.
“She wouldn’t have found that if not for the van coming to her work,” Malakoff said.
Last week, a board member called Malakoff to talk about the new recommendations: “Oh, I just turned 40,” she said. “I don’t have to worry about a mammogram for five years.”
Malakoff grimaced: “That’s the problem.”
So what’s the take-away from the recent recommendations?
“There is no take-away,” Malakoff said. “It’s B.S.”
No, really. Anything I can do to cut down time spent in a flimsy hospital gown, a breezy hall and a breast press is welcome.
It’s pretty simple, Malakoff said: Know your body.
“If I hadn’t been touching them and knowing my breasts, I wouldn’t have gone in,” she said of her diagnosis. “But it felt different.”
Ninety percent of her CanCan facilitators discovered their cancer on their own, she said, or at mammograms they had at 40.
So instead of getting confused, women need to be proactive. Know your family history. Talk to your doctor. Have genetic testing, if you think you might be at risk.
And if you want a mammogram, get one — no matter what the experts say.