If Daphne McNairy-a career woman, wife and mom of two young girls-had taken
this advice (her own, actually) and remembered to make her health as much
of a priority as her family, she believes her breast cancer may have
been caught earlier. But a harried schedule left little time for annual
mammograms and diligent self-exams. Today, a mastectomy and six rounds
of chemotherapy nearly two years behind her, McNairy is on the other side
of cancer. "So many women are always giving, always caring for someone
else. But if we're not taking care of ourselves, we really can't
be there for someone else," McNairy says.
Ursula Bobo agrees. Breast cancer hadn't run in Bobo's family until
her sister was diagnosed with the disease after having her first mammogram
at the recommended age of 40. This diagnosis panicked Bobo, she remembers.
In her early 30s at the time, she immediately booked an appointment
for her first screening. When the results showed a normal scan, she
took a deep exhale in gratitude and vowed to be better about regular self-exams
and annual mammograms.
A year later, when it was time for her second yearly screening, the
results dealt a blow: breast cancer. "I think there's a perception
among a lot of women that if there's no family history of breast cancer
or if you are healthy, you can let annual mammograms slide," Bobo
says. "In just one year's time, I went from a clean scan to an
aggressive cancer that had spread throughout my left breast."
The message that both these women want to impart: stay on top of your health.
Get an annual physical, go for your yearly mammogram starting at 40, combine
this with regular self-breast exams and know your body. You owe it to
yourself and to your loved ones.
The American Cancer Society (ACS) reports that an estimated 230,480 American
women will be diagnosed with breast cancer this year, and 39,520 women
will die from the disease. Found early, breast cancers are curable. Ductal
carcinoma in situ (DCIS), in which the cancer is only present in the ducts
of the breast and has not spread, is more than 99% curable. But early
detection is critical.
While scientific studies first proved more than 30 years ago-and again
more recently-that mammography is the most effective screening tool
for detecting breast cancer, numerous misconceptions about the procedure
and its effectiveness have swirled around in recent years.
Some of the latest controversy surrounding mammography is due to a 2009
report by the U.S. Preventive Services Task Force (USPSTF) that recommended
that most women under 50 did not need annual screenings. Instead, the
USPSTF said, screening for women in their 40s should be based on individual
risk factors, and women ages 50 to 74 should be screened every two years.
This news defied the guidelines set in place by the ACS and long maintained
by health professionals, who staunchly maintain that as a routine standard,
all women should have an annual mammogram starting at 40 years old. While
the USPSTF's recommendations left women scratching their heads
over when and how often to get a mammogram, other common misconceptions
surrounding everything from risk factors (no family history = no worries)
to the procedure (it's painful and can cause women undue stress) have
only complicated matters.
"Women are very confused, and the truth is, they have every right
to be," says Patricia Sacks, MD, medical director at the
Vasek & Anna Maria Polak Breast Diagnostic Center at Torrance Memorial. "There is a lot of misinformation floating
around, but what we know with certainty is that mammography has long been
shown to reduce breast cancer mortality by over 30%.
Sacks, a radiologist with more than 40 years experience in the field, and
other experts cite a long-term, renowned Swedish study conducted in the
1970s as proof that mammography is a valuable tool in saving lives.
The Swedish Two-County Trial, which traced the impact of mammography
on breast cancer mortality over the span of three decades, was the first
breast screening trial to show a reduction in breast cancer mortality
from screening with mammography alone. It found a 30% reduction in breast
cancer deaths among some 77,000 women ages 40 to 74 who were invited to
screen. The screening phase of the study lasted about seven years, with
29 years of ongoing follow-up.
Since technological advancements in mammography have been made in
the years after the study, many say the Swedish findings may actually
underestimate the benefits of regular screenings. The Polak Breast Diagnostic
Center, one of four located throughout the South Bay, sees 60,000 patients
each year. Some 350 cases of breast cancer are diagnosed there annually.
Since 1987, patients have received ultrasounds, MRIs and biopsies in addition
to routine screenings.
Breast cancer survivors Bobo and McNairy were screened at the center. Along
with Sacks, they too have heard similar reasons from too many women who
don't make mammography a priority. "I tell people there's
nothing to be afraid of in getting a mammogram," Bobo says. "You
owe it to yourself and your family. I think it's selfish not to have
Many women are worried about the procedure being painful. But Sacks says
that each view taken during screening takes only a few seconds. "It's
worth putting up with a bit of discomfort for a year of peace of mind,"
she tells them. She encourages women to plan their annual mammogram
between periods, preferably around the same time every year, and to take
an Advil one to two hours prior to the procedure.
Another common myth associated with breast cancer? "People operate
under the illusion that if there's no family history, there's
no risk of breast cancer," Sacks says. While it's true that having
two first-order relatives (a sister, daughter or mother) with breast cancer
equals a higher risk for the patient, seven out of eight cases of breast
cancer occur in women with no family history of the disease.
Sacks encourages a risk assessment and an MRI for women if there is
any reason to think they are at high risk for breast cancer. For patients
whose risk is defined as being 25% greater than that of the community
at large, insurance will generally cover the cost of an MRI.
"The truth is, we don't know all the factors that cause breast
cancer," she says. "Family history is one factor, but lifestyle
choices-obesity, heavy drinking, etc.-are also believed to play a
When it comes to family history, the screening guidelines change. "If
a patient's mother had breast cancer at 47, we would recommend the
patient start having mammograms 10 years before that and continue until
she is 85 years old," Sacks says.
Some women are simply afraid of getting a call-back from the radiologist.
"A great myth is that if we ask a patient to have a biopsy, it means
the tumor is cancerous," Sacks says. "But often the biopsy comes
Nationwide some 800,000 to 1.1 million biopsies are taken each year. For
women who are called in for a biopsy, Sacks emphasizes the importance
of a needle biopsy over a surgical biopsy. This way, doctors can see the
tumor marker and know how to treat the cancer. Crucial information-since
in most cases, a small breast cancer removed with a lumpectomy followed
by radiation has long been known to have the same cure rate as a mastectomy,
"Even when the breast is removed, the reconstruction work today is
just amazing. We've come a long, long way. Plus, some of the advancements
on the horizon are very exciting." Sacks has been collaborating
for the past six years on a tool that, when introduced, promises to significantly
reduce the number of biopsies. In the meantime, women must be proactive
about breast health. Sacks reminds women at any age who feel a lump to
see their doctor and have a mammogram.
Dawn Fuh, mother of three, had no first-order relatives with breast cancer.
Today she's undergoing chemotherapy treatment after being diagnosed
at Stage II. Fuh was diligent with routine mammograms and self-exams,
and she found the lump between her annual physical and mammogram appointments.
The center discovered that cells from the lump had already spread to her
lymph nodes. Fuh underwent a lumpectomy and the removal of lymph nodes,
and radiation will follow her chemo treatments. "I know people who
say they haven't been for a screening in five years," she says.
"My best advice is to not be afraid and to just go. It only takes
minutes. It's worth the trip, and it could be a lifesaver."
Bobo's battle with breast cancer taught her to live her life to the
fullest and to be grateful for every day, every new experience. Years
had passed since her mastectomy. Then one day in 2009, Bobo came
across a knot in the same breast. It was the size of a pencil eraser and
painful. Scar tissue from my surgery, she thought. But a gut instinct
kicked in, and Bobo paid another visit to the center.
Her cancer had returned. A lumpectomy, chemotherapy and radiation
followed. Today, two years later, Bobo is again cancer-free. A butterfly
and pink ribbon tattoo reminds her to be free and to not carry the weight
of the world on her shoulders.
"I take each day as it comes," she says. "I don't always
feel 100%, but I'm glad to be alive and well, and every chance I get,
I encourage other women to be proactive with mammograms and stay on top
of self-exams. Never take for granted a lifetime of living healthy."