New Guidelines for Breast Cancer Screens Makes Some Happy, Some Mad and Most Confused

The American Cancer Society has released new guidelines for breast cancer screening. Among the changes, the new recommendations say all women should begin having yearly mammograms at age 45, and can change to having mammograms every other year beginning at age 55.

But this new change, while a relief to some, brings confusion to the issue, and angers some survivors. The confusion comes from the face that three key groups — the American College of Obstetricians and Gynecologists, the American Cancer Society, and the U.S. Preventive Services Task Force — recommend different ages for starting regular mammograms: 40, 45 and 50 respectively. The reason for that? Everyone agrees that while mammograms save lives, they can also cause harm, and each group does a different job of balancing the pros and cons.

The new American Cancer Society recommendations

• Women with an average risk of breast cancer – most women – should begin yearly mammograms at age 45.

• Women should be able to start the screening as early as age 40, if they want to.

• It’s a good idea to start talking to your health care provider at age 40 about when you should begin screening.

• At age 55, women should have mammograms every other year – though women who want to keep having yearly mammograms should be able to do so.

• Regular mammograms should continue for as long as a woman is in good health.

• Breast exams, either from a medical provider or self-exams, are no longer recommended. Still, the American Cancer Society says all women should be familiar with how their breasts normally look and feel and report any changes to their health care provider right away.

• The guidelines are for women at average risk for breast cancer. Women at high risk – because of family history, a breast condition, or another reason – need to begin screening earlier and/or more often.

Talk to your medical provider to be sure.

Earlier testing is not necessarily better

The goal of screening mammograms is to find breast cancer early, when treatment is more likely to be successful. But mammograms aren’t perfect, and they have a relatively high false positive rate. In these cases mammograms find something suspicious that turns out to be harmless, but must be checked out through more tests that also carry risks including pain, anxiety, and other side effects. Experts weigh these benefits and risks when making recommendations about who should be screened.

An exhaustive review of the medical literature shows these measures just aren’t very effective, according to the group. “The chance that you’re going to find a cancer and save a life is actually very small,” said Dr. Otis Brawley, the society’s chief medical officer.

The chances of false positives are especially high for women under 45, as they have denser breasts and tumors are harder to spot on an image. “If she starts screening at age 40, she increases the risk that she’ll need a breast cancer biopsy that turns out with the doctor saying ‘You don’t have cancer, so sorry we put you through all this,'” Brawley said.

He said he knows women who’ve had false positives year after year. “False positives are a huge deal,” he said. “These women are so frightened and inconvenienced they swear off mammography for the rest of their lives.”

“We know that debates will continue about the age to start mammography,” said Dr. Wender. the Society’s Chief Cancer Control Officer, “This guideline makes it so clear that all women by age 45 should begin screening – that’s when the benefits substantially outweigh the harms.”

New guidelines have their critics

While agreeing with the American Cancer Society that mammograms aren’t perfect, according to an CNN interview some advocates for women criticized the group’s new guidelines. First, they said the society looked mostly at studies of film mammography, which in the United States has almost been entirely replaced by digital mammography.

Digital mammograms generate clearer images and do a better job of finding cancer and have a lower false positive rate. “It’s like standard versus HD TV,” said Dr. Therese Bevers, the chair of the National Comprehensive Cancer Network’s guidelines panel for breast cancer screening and diagnosis, and the medical director of the Cancer Prevention Center at the MD Anderson Cancer Center.

Second, critics said the cancer society looked only at whether screening saved a woman’s life, and not at whether screening caught a cancer early, so the woman could avoid the most drastic treatments, such as chemotherapy or mastectomy.

“The American Cancer Society made the value judgment that screening is only worth it if improves survival,” said Dr. Marisa Weiss, a breast cancer survivor and president of Breastcancer.org. “There’s an arrogance to that. Let women decide what’s meaningful to them.”

Insurance companies will make the final decision

While the new guidelines state that women over age 55 can choose to get a mammogram every other year, since breast cancers in post-menopausal women tend to develop more slowly to a great extent it will be insurance companies that decide at what age women get mammograms. In 2009, they typically continued to pay for mammograms starting at age 40 even though the government’s task for force recommended mammograms starting at age 50.

But it’s not clear what they’ll do now that the American Cancer Society has also raised the age for mammograms. “(Insurance) plans will certainly take these updated recommendations into account when evaluating their coverage policies,” Clare Krusing, a spokeswoman for America’s Health Insurance Plans, wrote to CNN.

Talk to your doctor

For now the best way to know when to begin screening for mammograms and how often to get screenings is to talk to your medical provider.

• Begin talking to your medical provider about breast cancer screening by age 40.

• Share your family history and personal medical history to determine whether you are at average risk or higher risk for breast cancer.

• Understand the benefits, risks, and limitations of breast cancer screening. Mammograms will find most, but not all breast cancers.

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How Surrogates Help Breast Cancer Survivors

As Breast Cancer Awareness Month nears the end of October, pink ribbons provided a reminder and moment of silence for those touched by cancer while offering a medical cue to schedule a mammogram. Decades ago, it was a disease plagued by stigma. But with celebrities having spoken out about their personal experiences with their own breast cancer surgeries, treatments and reconstruction procedures, the stigma has been demystified and women have become empowered.

Cancer does not discriminate. It affects women of all ages, including those who are still in their reproductive years. When a woman hears such a diagnosis, following the shock and fear, she glances ahead at what awaits her which may include surgeries, radiation, and chemotherapy.

As the executive director of an international egg donation and surrogacy agency, some women who are unable to become pregnant and carry their own children may require a surrogate after having undergone cancer treatments. While some women are able to become pregnant after treatments, there are a group of women who face infertility.

Each patient is unique and so is the treatment her medical experts may recommend. Nevertheless, if a woman has not started or completed having her family, she comes at a crossroads after her diagnosis. Through the remarkable strides of third-party reproduction, before a woman begins her treatments she has the choice to harvest her eggs and have them frozen.

Rather than being reactive regarding any future infertility issues, women can now be proactive. In addition to teaming up with her medical specialists, she can also partner with a fertility doctor if she desires children in the future.

The mere act of harvesting a woman’s eggs can be quite beneficial for her psychologically. While breast cancer has the ability to make a woman feel that she has lost all control, on the road of preservation fertility, she feels in control with a renewed sense of hope and something to look forward to: a baby.

Once a breast cancer patient becomes a breast cancer survivor, the timing is perfect to begin building a family. As mentioned earlier, while some women are able to become pregnant at a later date, others may be unable to become pregnant or carry a baby to full term.

And this is where a surrogate can step in and help a survivor. Women who want to become surrogate mothers do so for their own personal reasons. And one may very well be helping a woman who has fought the fight of breast cancer and is ready to rekindle that light of hope in having a baby.

To be able to help a woman who has endured multiple surgeries and treatments is immeasurable to a surrogate. And conversely, a survivor cannot begin to find the right word of thanks to say to their surrogate for the priceless gift of a baby.

The surrogate’s picturesque moment is of an intended mother holding her newborn for the very first time. It creates the memory of a lifetime.

Surrogates help break down breast cancer barriers by helping survivors live the full life they were meant to have through motherhood.

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Important Things You Must Know About a Mastectomy

Mastectomy is a broad term for different procedures. Apart from removing one or both breasts, this term also refers to removing lymph nodes in the armpit area in order to know if the cancer has spread.

Types Of Mastectomy

Simple – This will involve the removal of the entire breast – these include the areola, nipple, and breast tissue. Often, a sentinel lymph node might be done during this procedure.

Modified Radical – This will involve the removal of the entire breast, which includes the areola, breast tissue, nipple, and most of the lymph nodes in the armpit. This procedure might be recommended for big tumors or when the cancer has spread to the lymph nodes already.

Nipple-sparing or subcutaneous – This will involve the removal of the breast tissue only, leaving the areola and nipple. Immediately afterward, breast reconstruction will be done.

Skin-sparring – This will involve the removal of the areola, nipple and breast tissue but not the breast skin. Breast reconstruction will also be performed after. This is not recommended for larger tumors.

In case you do not want to undergo breast reconstruction, you can just opt for breast prosthesis, which is a breast form made of foam, silicone gel, or other materials. It can either be placed directly on top of the skin or perhaps in the pocket of a special bra. It is highly advised that you consult with your health care provider before choosing this option. He or she will help you choose the best type that will fit your lifestyle. Know that this can only be properly fitted weeks after the breast removal procedure.

What To Look For In Mastectomy Garments

It must be custom fitted to the user.

It must come in different materials, styles, and types to properly support all the activities of the user.

It must be of high-quality. A reliable indication of quality is how even and tight the stitches are.

It must come with a guarantee. This will make sure that the item has the best fit and production quality. Also, choose a brand offering great customers service for checking up on how the garments are working for the user’s benefit.

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