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Kathleen Reardon

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I'd Be Dead By Now -- The New Breast Cancer Guidelines

Posted: 11/17/09 10:50 AM ET

I'd be dead by now if it weren't for breast self-examination. And had my doctor been less convinced of his own guidelines regarding women without a known history of breast cancer, my cancer would have been detected earlier and I would have been treated sooner and less aggressively. I was 32 years old.

Does this mean the findings of the study about to change women's lives are worthless or tainted by the influence of insurance companies and planned medical cutbacks? Can't answer that yet, but I'd hate to think so.

I'll say this. I'm a social scientist with nearly twenty years conducting preventive medicine research. Research by leading scientists is informative, often instructive, but never the last word. And that is how most of them think as well. Even the best research can be influenced by the desires of those conducting it, those sponsoring it, guidelines for publication, and a host of other factors. This is why replication is so important. But even when studies are repeated, it is possible for biases, errors and oversights to be so as well.

The latest research is one more piece of information for the decision process women must make each year regarding mammography. That's it. If breast self-exam gives you greater peace of mind, no set of guidelines should deter you from it. If someone in your family found a lump in her breast that turned out to be breast cancer, what a team of doctors and researchers tells you is simply one piece of advice and perhaps irrelevant to your situation.

They are researchers looking at numbers. You are a person they do not know.
I have high regard for many of the doctors weighing in on this subject, but let me bring it back to you, your wife, mother, sister, or friend. Anecdotal information is valuable. It is part of the larger picture. You also need to know yourself. If you're more interested in being sure than worried about being scared, find yourself a doctor who agrees with you. And get the mammogram recommended by the American Cancer Society before the insurance companies take that option away.

Can you overdo worry about breast cancer? I suppose so. But gum disease concerns me too and no study is going to convince me to stop flossing. So, ignore all this condescending talk about women worrying and how we should be protected from our nervous selves and instead take the findings of the research as useful, additional information.

To your family and yourself, you are not a number. And your life is different from that of the people who seem to have the answers. Do what's best for you. I've found that fighting cancer is a bit of a crap-shoot anyway. The guidelines keep changing. Treatments improve. And you might in hindsight wonder if a different approach would have spared you some later problems. But there's much to be said for being glad that you're still here.

Later today I'm heading over to the YMCA to Lance Armstrong's Livestrong exercise program for cancer survivors. I don't think I'll find many people there saying, "I wish I'd known not to bother looking out for cancer at my age" or "I wish some doctors had protected me from worrying." No. We're going to enjoy our exercise thanks to Mr. Armstrong and the YMCA and be glad that when it came to our decisions, we did, after relevant information was considered, what seemed right for us.

Dr. Reardon also blogs at bardscove.

 
 
 

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