{"id":541,"date":"2001-09-08T00:00:00","date_gmt":"2001-09-08T00:00:00","guid":{"rendered":"https:\/\/1millionbestdownloads.com\/mind-body-your-top-10-most-urgent-breast-questions-answered\/"},"modified":"2001-09-08T00:00:00","modified_gmt":"2001-09-08T00:00:00","slug":"mind-body-your-top-10-most-urgent-breast-questions-answered","status":"publish","type":"post","link":"https:\/\/1millionbestdownloads.com\/mind-body-your-top-10-most-urgent-breast-questions-answered\/","title":{"rendered":"Your Top 10 Most Urgent Breast Questions Answered"},"content":{"rendered":"
For years, Id written about breast cancer from every possible angle. Then, all of a sudden, I was living it. My aunt and mother were diagnosed 15 and 8 years ago, respectively, and then my aunt got ovarian cancer<\/a> as well. To confirm my suspicions of a family connection, I got tested for the BRCA genetic mutations. I did, indeed, have BRCA1 and what comes with it: a roughly 60 to 80 percent lifetime risk of one day developing breast cancer and a likewise-inflated risk of getting ovarian cancer.<\/p>\n I was determined to take some control. In 2007, I wrote in the pages of Health about having my ovaries removed, but I wasnt ready to even consider parting with my breasts. Instead, I went the surveillance route, trembling before every mammogram, undergoing magnetic resonance imaging (MRI)–guided biopsies, ultrasounds, and one surgical biopsy, all of which found nothing. As time went on, though, my D-cups felt more and more like time bombs, so last fall I decided to book a prophylactic double mastectomy—to save myself some psychic stress.<\/p>\n Coincidentally, just as I was setting up my surgery, the U.S. Preventive Services Task Force (USPSTF) announced a controversial set of guidelines for women, including that age 40 was too early to begin routine mammograms (for average-risk women, anyway). The new recommendations, which Health wrote about last month, caused women their own psychic stress, because they flew in the face of what wed all been told for years. I took the information I had and made some decisions, but many women were left with more questions than answers.<\/p>\n To help you figure out how best to take care of your breasts, we corralled the nations top experts and asked them the questions youve told us are on your mind. Cant find all your answers here? Bring this story to your next checkup to help you work out a plan of action.<\/p>\n Next Page: 1: Im confused—what happened to routine mammograms at 40?<\/a> [ pagebreak ]<\/p>\n 1: Im confused—what happened to the universal recommendation that every woman should start routine mammograms at 40?<\/strong><\/p>\n Of course youre confused. That advice had become conventional wisdom for the early detection of breast cancer. The thing is, while mammograms reduce the risk of dying from breast cancer, the task force also weighed the downside to screening women of average risk in their 40s.<\/p>\n They couldnt ignore the numbers: For every woman whose life is extended by starting screening at age 40, about 1,000 women will have a false-positive mammogram, explains Russell Harris, MD, a USPSTF panel member and a professor of medicine at the University of North Carolina.<\/p>\n False positives are scary and lead to more tests and biopsies, and mammograms may lead to treatment of breast cancers that dont need to be treated. For most women in their 40s, the guidelines suggest, the downside of following up on what is highly unlikely to be cancer may be greater than the small chance of finding a cancer early.<\/p>\n 2: But what if youre one of the few women whose life would be saved by a mammogram in her 40s?<\/strong><\/p>\n No one can guarantee that you wont be, and breast cancer in younger women tends to be more aggressive. Whether to start getting screened in your 40s comes down to your comfort with risk. What researchers know for sure is that most breast cancer is found in women older than 50 and that its critical to be aware of your risk factors.<\/p>\n For that, talk to your doctor. “Id caution a woman that its nearly impossible for her to calculate for herself if shes at average or high risk,” says Christine Laronga, MD, program leader of the Comprehensive Breast Program at the Moffitt Cancer Center in Tampa, Florida.<\/p>\n 3: So should I get mammograms starting at 40 or not?<\/strong><\/p>\n If you are at high risk, yes, start getting them at 40 (or even earlier). Assuming youre at average risk, you should do what feels right.<\/p>\n “If youre OK with the possibility of false positives and the anxiety that may go with it, you should go ahead and get your mammograms in your 40s,” says Laura Esserman, MD, director of the Carol Franc Buck Breast Care Center and professor of surgery and radiology at the University of California, San Francisco. But if you think the worry would be too much for such a small likelihood that you have breast cancer, then you might want to hold off.<\/p>\n Next Page: >4: How do I know if Im high-risk?<\/a> [ pagebreak ]<\/p>\n 4: How do I know if Im high-risk?<\/strong> 5: Ive heard that mammograms dont catch certain cancers. Why?<\/strong><\/p>\n Mammography isnt perfect, says Constance Lehman, MD, PhD, head of breast imaging at the University of Washington and Seattle Cancer Care Alliance in Seattle. Then again, nothing is perfect, and theres no doubt that mammograms save lives. The trouble is, these scans can find cancers in the form of a mass, calcification, or distortion, but they also detect benign forms of these abnormalities.<\/p>\n And if a cancer is very aggressive, theres a chance it could develop during the time between your mammograms and simply not be there to catch or not be big enough to see. Plus, there are cancers that dont produce malignant calcifications or dont develop as a mass, which are more likely to be missed by mammograms.<\/p>\n That said, one Harvard study projected that women who dont get screened would have a 56 percent mortality rate if they developed breast cancer, while just 5 percent of those who do get screened would die if they got cancer. Researchers are working on other ways to identify breast cancer early, including measuring circulating tumor markers in the blood. In the meantime, its clear that being screened routinely is a wise move.<\/p>\n Next Page: 6: What are high-risk women to do?<\/a> [ pagebreak ]<\/p>\n 6: Given mammographys limitations, what are high-risk women to do?<\/strong><\/p>\n If youre at high risk, the new guidelines dont apply to you. High-risk women should start getting mammograms at 40 or younger while being closely monitored (often with an MRI and a mammogram alternating every six months and two clinical breast exams a year) and perform monthly self-exams. Some women opt for chemo-prevention drugs such as tamoxifen.<\/p>\n The most risk-reducing option—and also the most radical—is a prophylactic double mastectomy, which decreases your lifetime odds by at least 90 percent. “Its often peace of mind that drives your decision when youre at high risk,” Dr. Shapiro says.<\/p>\n 7: Why are some doctors not following the new guidelines?<\/strong><\/p>\n Even though there are limitations to mammography, says Otis Brawley, MD, chief medical officer of the American Cancer Society, which strongly disagrees with the new recommendations, its what we have for now.<\/p>\n “We think that if you inform people ahead of time of those limitations, its still appropriate to recommend [mammograms] to young women.” Whats more, he says, a higher proportion of women in their 40s with breast cancer have aggressive forms of the disease, and many of these women may benefit from regular screenings.<\/p>\n 8: Arent these new guidelines really about money, since it reduces costs to screen women less often?<\/strong><\/p>\n Dr. Brawley doesnt think the panels decisions came down to cost cutting. According to panel members, money was not a consideration. Rather, the task force focused on the inconvenience of mammograms and the fear, callbacks, and anxiety that they provoke.<\/p>\n Concerns about the risk of overtreatment weighed heavily, too. If you feel you need a mammogram and are in your 40s, Dr. Brawley advises, get one and fight for reimbursement if your insurer says it wont cover it.<\/p>\n Next Page: 9: Ive had scares in the past<\/a> [ pagebreak ]<\/p>\n 9: Ive had scares in the past, none of which were cancer. Should I be doing anything differently?<\/strong><\/p>\n Probably not, but talk to your doctor about whether you should be screened as frequently. Some women are simply more likely to develop abnormalities that can masquerade as breast cancer on a mammogram, says Therese Bevers, MD, a professor in the Department of Clinical Cancer Prevention<\/a> at The University of Texas M.D. Anderson Cancer Center in Houston.<\/p>\n If youve had false alarms, remind yourself that more than 80 percent of callbacks are nothing to worry about. Try to think of them as a way to confirm that the finding is, once again, nothing. Another thing you can do: cut down on caffeine if it makes your breasts sensitive, or schedule your test just after your period. Why? “The less sensitive you are,” Dr. Bevers says, “the better compression well probably get,” which makes for a more revealing mammogram.<\/p>\n 10: I just read that aspirin can lower my breast cancer risk. True?<\/strong><\/p>\n The jury is out on this. “Some previous research shows that aspirin reduces breast cancer risk, but one trial tested a small dose of aspirin compared with a placebo and found no effect on risk. So either aspirin doesnt work or perhaps the dose was too low,” says Anne McTiernan, MD, PhD, of the Fred Hutchinson Cancer Research Center in Seattle.<\/p>\n Dont be confused by the results of the new aspirin study published in the Journal of Clinical Oncology. It suggests that the drug, when used by women who have already been diagnosed with breast cancer, cuts the risk of dying from the disease by up to 71 percent. But the findings do not apply to women who are cancer-free, Dr. McTiernan says. In short, do not take aspirin in hopes of preventing cancer; daily long-term use of the drug poses serious risks of stomach bleeding.<\/p>\n
For younger women, “Family history and BRCA mutations are the most telling risk factors,” says Richard Shapiro, MD, associate professor of surgery at The Cancer Institute at the New York University Langone Medical Center in New York City. Heres why, below, as well as the other important factors to discuss with your doctor:<\/p>\n\n
is a breast cancer risk factor. For more details on what raises your breast cancer risks, visit Health.com\/risk-factors.<\/li>\n<\/ul>\n