Mammogram controversy


As a nurse who has worked in the surgical field for 11 years I am baffled by the new recommendations from the U.S. Preventative Services Task Force. One of the new guidelines is women should not be taught to do self breast exams. Another is that mammograms are not recommended until age 50, instead of age 40; they are to be done every two years rather than yearly. Herein lies my confusion; the American Cancer Society does not agree with these new recommendations. I have assisted with hundreds of breast surgeries ranging from simple biopsies to full mastectomies.

My grandmother had breast cancer (key word here…HAD), her tumor was diagnosed early from a yearly mammogram. She quickly underwent surgery and a lumpectomy was performed. This is where they remove the tumor and surrounding tissues, instead of removing the whole breast. The removed lump is sent to the lab to be screened for cancerous cells around the margins of the tissue. Luckily my grandmother had clear margins and she did not have to undergo chemotherapy nor radiation. She has been cancer free for over 15 years now.

I realize I am no physician but, I do have common sense. Why as a woman, or man for that matter not continue self breast examinations? It’s a simple concept, whoa, there’s a new lump…what to do? Well, I guess now if you find a new lump, bump or abnormality it’s no big deal, after all most lumps are not cancerous if you are under 50. We sure know that young women or men never develop breast cancer…oh that’s right…YES THEY DO!! So I think I will stick with the advice of the American Cancer Society and go see my physician. I will let my Dr. decide along with the proper measures i.e. mammogram, needle aspiration, ultrasound rather my “lump” is benign or cancerous. I don’t know about you but I would much rather undergo a lumpectomy vs. a  mastectomy!! What do you think?

  • 7 Comments...Your thoughts?


  1. atyourcervix says:

    I’m in the process of a Health Promotion class project where we need to identify (on a lovely grid) all of the screenings, recommended age to start, how often to do them, etc, all based on the USPSTF recommendations. I find it appalling to read the conflicting information that our US Govt places on that site. Do NOT recommend monthly SBE? Mammograms starting at age 50, and every 2 years? What the heck? I’ll be sticking to the prior recommendations of starting at age 40 and having them done annually.

  2. I could not agree with you more. One thing that worries me even more, it seems the American cancer society has worked so hard to spread awareness and education. Now, we are not supposed to educate our patients, our daughters on self exam? I promise I will educate my daughter on the importance of breast care health! Thank you for your support :)

    • As a member of the American Society of Breast Diseases and the American Society of Breast Surgeons, these recommendations caught me by surprise. It would appear the basis for the recs of increasing the age for standard mammogram has to do with false negatives. Of all woman that get breast biopsies, 80% are negative and that number I would guess is higher in woman under 50. I need to read more, but I am sure that there is going to be a lot of controversy about this.

  3. What about the 20% that were positive? I had a negative biopsy myself at age 28 bu,t it sure gave me peace of mind to know it was fibrocystic rather than cancer. I found the lump on self breast exam. How many patients have you seen that came to you from self exam?

  4. atyourcervix says:

    But, to be in that 20% with positive biopsies? I would rather have a negative biopsy, than have something cancerous be brewing and have not been biopsied.

  5. Dr Ron Hekier says:

    I am not taking a side until I review all the literature. However, don’t ignore the false postives. What is acceptable, 80%, 90%, 99% , 99.99%?
    What if someone has a reaction to anesthesia and dies for a breast biopsy that had almost no chance of being a cancer?

  6. I would surley take my chances on a possible anesthesia reaction to attain a negative biopsy, to me it’s worth the risk of surgery.

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