Friday, April 27, 2012

When kancer guidelines kollide with experience

My mom mailed me a care package, including the April issue of Alive which is chock-full of articles on the cancer - I highly recommend it. However, one article, "Breast Cancer Screening", left me confused.

New breast kancer screening guidelines

Last year, the Canadian Task Force on Preventative Health Care released new breast cancer screening guidelines. Highlights pertaining to women 40-49 that jumped out at me:

  • Routine screening mammograms: not recommended
  • Regular self breast exam: not recommended
  • Regular breast exam performed by a doctor: not recommended

An unremarkable history

At 39, I'm a year shy of being a member of this age group. I've always been sporadic about performing self exams, because I didn't fit into the high-risk category.

There is no breast cancer in my family, except for my cousin Pam, and we are not related biologically. I'm active on a regular basis. I drink (or rather, drank), but limited it to weekends, generally moderately. I quit smoking several years ago. I breastfed.

In other words, I'm like a lot of women my age.

My kancer diagnosis

Like I said, I was sporadic with the self exams. I noticed some skin that looked off on my left breast. I get eczema, so thought little of it at first. Then I decided to check. Aha! A lump.

I booked an appointment with my family doctor. He checked. "I've felt a lot of cancer, and this doesn't feel like it. But because of the skin discolouration, let's send you for an ultrasound," he told me.

I was referred to Mount Saint Joseph in Vancouver, which I learned is *the* place to go for screening and treatment. They decided to give me a mammogram, then ultrasound.  And the rest, as they say, is history.

Where does this leave women

So the new recommendations have me wondering what women are supposed to do. I turn 40 later this year. Friends who have already reached the milestone and have been putting off their first mammogram have told me they'll now get it because of my experience.

I didn't think I had cancer. My doctor didn't think I had cancer. And my surgeon and oncologist agree I didn't fit into the high-risk category. 

That mammogram may have saved my life.

My humble opinion and a pitch

Trust your gut. If you think something is wrong, pursue it. If you don't agree with a doctor, get a second opinion, or a third. Be your own best advocate!

And in honour of Daffodil Day, I plug Mount Saint Joseph's fundraising campaign for a second mammogram machine.

There is a fundraiser on Saturday, May 12 at the Riverside Grand Ballroom. Tickets cost $75 a pop.

If you can't go, want to donate a different amount, or want more info, contact: 


  1. SELF exams are not recommended??? Exams from your doctor are not recommended??!!??!!


    This is seriously disturbing.

    So, I really am curious about this, Lori. What is the rationale behind this? I'd really like to this something your doctor could speak to?

    What a load of KRAP.


  2. BTW - I really enjoy that image. It brought a giant curl to my lips. :-)

  3. You can't beat Shatner, although I'm not so sure about his mammogram technique!

    Yeah, I'm going to look into it and see what the rationale is behind the new guidelines. I have read about false positives and unnecessary biopsies. I'd rather go through the stress of testing, and find out I don't have cancer, than find out I have stage 4 cancer because it wasn't caught as early as it could have been. But I'm no doctor.

    I also worry that these guidelines can feed the myth that breast cancer doesn't happen to women younger than 50, especially active women with no family history of breast cancer. We aren't in the majority, but we exist. I have had more than one nurse following my surgery (both in the hospital during a homecare visit) tell me they are seeing more young patients.

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  5. Mammograms and self-exams not recommended? What the...? What on EARTH could the rationale for this be?

    1. I don't know if it has to do with what's perceived as a lower risk for women under 50, but I think it's nuts. Like I said to Mewdell, I'd rather go through the stress of tests and waiting for results to find out it was benign than wait until I'm 50 and find out I have stage 4 cancer.

  6. Good post Lor. Reminds me of when I first started seeing my family doctor (who is amazing) and she asked why I hadn't had a pap smear in over two years. I told her that my last doctor said that guidelines had changed and if you'd had normal results you didn't need to be tested regularly, which included the breast exam. She said, "You know why they say that? It's to save money. I don't agree and I don't follow those rules."

    When I saw the new recommendations on mammograms that was the first thing I thought of: they want to save money. Hard to know if it's true, but the recommendations really don't make sense.....

    1. A nurse I know says it's to save money. Disheartening, to say the least.

  7. Instinct is an interesting one though--so many people I know who have had cancer say they knew it instinctively. Though I have to admit every checkup I have I now 'instinctively' know something is wrong again when it turns out not--I still would take a check-up and the stress of a false positive over the alternative any day...

    1. I'm guessing the line between "instinct" and "shit, it's happened once so it can happen again" is a fine one after you've been treated for cancer.