Common Sense (Not Statistics) Should Guide How Often Women Have Mammograms

Even though breast cancer is discovered less often in African-American, Hispanic, and Native-American women, they are more like to die from it–perhaps because they simply can’t afford to pay for a yearly mammogram and/or a clinical breast exam.   Even so, when breast cancer in these groups is detected, the tumors act more aggressively. 

Similarly, a lot of women (such as myself) who are self-insured and/or have a high deductible that doesn’t necessarily pay for mammograms alternate a bi-annual mammogram with a bi-annual visit to the gynecologist since their budget doesn’t always allow for both expenses each year.  Naturally, breast cancer survival is highest when a tumor is small and it hasn’t spread beyond the breast.

Of course, breast cancer detection statistically rises in European and European-American women, in women with higher incomes, and in women with higher levels of education.  Moreover, in the United States, these women are more likely to have employee-based health-insurance that currently pays for such exams.  Women also are more likely to develop breast cancer if they delay childbearing until they are over thirty or else they never have had children.  Conversely, women who have children at younger ages, blue- and pink-collar women, and women without a college education are less likely to be diagnosed with breast cancer than their “professional” sisters, although they are more likely to develop cervical cancer, which can be detected by a pap exam (which the Task Force has also recommended administering less regularly).* 

To be perfectly fair, false positives do show up because non-cancerous cysts and tumors can look very much alike, necessitating either ultra sounds or biopsies, and thus increasing the costs of preventive medicine.  Even so, breast cancer is the second leading cause of cancer death in women after lung cancer, and tumors in minority women are often more aggressive than those of Caucasian women (who ordinarily catch these cancers comparatively early). Then again, the problem of dealing with statistics rather than individuals fails to factor in other, very individual risk factors, including

• a first-degree relative (a mother or sister) who has been diagnosed with breast cancer,
•  taking estrogen-based birth control pills over a lengthy period of time, 
•  failing to maintain a healthy body weight,
• overly dense breasts 

Although the Preventive Task Force warned that their recommendations don’t apply to those women with a higher risk of breast cancer, most women–whatever their racial or economic background–probably don’t associate having a high risk for breast cancer with any factor other than a first-degree relative who has had it.

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Since mammograms in the near future in the US are more likely to be rationed either by government edict or by private insurance companies, all women in self defense should adopt some preventive measures that deter or more easily detect breast cancer.  For example, a woman in her early twenties should have a clinical physical breast exam coupled with easily understood instruction on exactly how a normal breast should feel.  The American Cancer Society and the American College of Obstetrics and Gynecology, who disagreed with the US Preventive Task Force findings, also suggest that all women should have a clinical breast exam every three years during their 20s and 30s.  

However, these doctor visits also have their drawbacks–just as a mammogram often fails to distinguish between non-cancerous cysts and tumors, physicians also often have trouble determining which is which by touch.  Because of all these complications in determining whether a woman has breast cancer, all women should understand that a healthy life-style can also minimize the risk of breast cancer.  Accordingly, it would be wise to

• Maintain a healthy body weight, depending on age and height;
• Minimize intake of alcohol–a drink a day increases breast cancer 20 to 25 percent (while conversely cutting cholesterol and the risk of cardiovascular disease);
• Eat lots of citrus fruits and green and leafy vegetables (for example, broccoli, cabbage, Brussel sprouts, and spinach);
• Avoid the over consumption of white flour, white rice, and white potatoes;
• Take multi-vitamins geared to age and gender;
• Consume (Omega-three) fatty fish–salmon, mackerel, tuna, trout, and herring–several times a week while minimizing intake of beef and/or take a fish-oil/krill supplement, upon consulting a physician since this also thins the blood;
• Cook with mono-saturated fats (canola, olive oil);
• In short, follow a similar diet plan to those recommended to lower cholesterol except for drinking a glass of wine daily.
• Perform weight-bearing exercise (walking, jogging, dancing, for instance) for thirty minutes at least five days a week;
• Avoid estrogen-based birth control and as a cure for the complications of osteoporosis and menopause.

A little common sense and a relatively inexpensive mammogram obviously can go a long way in preventing breast cancer.

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*Hispanic, Asian, and Asian-American women are more likely to develop cervical cancer than European, European-American, and African-American women.