Posted by on October 25, 2013 - 2:56pm

As women, sisters, wives, friends, mothers, daughters, and grandmothers, we must make sure that we are doing everything in our power to be at the top of our health, always. We are depended upon to set the healthy example for family and friends around us. Breast cancer and cervical cancer is not something that we can completely prevent or predict on our own, but as women, we do face these two possibilities and it is worth our while to keep our health as updated as possible.

To many women, getting a breast exam or a Pap smear tends to sound easier than it is, but it’s not just about making the appointment. There are many aspects of getting these periodic exams that are not addressed and that can many times be the cause of why women postpone these exams and a possible diagnosis or treatment. It is always more difficult to ignore what needs to be done because of fear of a diagnosis, fear of machines, or fear of the unknown. However, there is so much more put at risk when responsibility to our health is neglected.

So why do some women fail to follow through with these periodic exams? An article in the American Journal for Public Health, 1993 took a look examining demographics. The results of this study revealed that the most likely to NOT go in and get the necessary breast or Pap smear exams at the appropriate times were:

  • Low income
  • Hispanic ethnicity
  • Low educational attainment
  • Over 65
  • Living in a rural area
  • Never been married

The following is recommended:

  • Yearly mammograms are starting at age 40 and continuing for as long as a woman is in good health
  • Clinical breast exam (CBE), an exam of the breast performed by a health care provider to check for lumps or other changes, about every 3 years for women in their 20s and 30s and every year for women 40 and over

Know your body and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20’s.

  • Starting at age 21, have a Pap test every 2 years.
  • If you are 30 years old and older and have had 3 normal Pap tests for 3 years in a row, talk to your doctor about spacing out Pap tests to every 3 years.
  • If you are over 65 years old, ask your doctor if you can stop having Pap tests.

Ask your doctor about more frequent testing if:

  • You have a weakened immune systembecause of organ transplant, chemotherapy, or steroid use
  • Your mother was exposed to diethylstilbestrol (DES) while pregnant
  • You are HIV-positive
    For information on how to "Prevent Yourself from Breast Cancer," click here. 


Posted by on November 19, 2009 - 7:39pm

It’s been all over the news this week--the US Preventative Services Task Force came out with a new set of recommendations for breast cancer screening, including recommending against yearly mammograms for women ages 40-49.  Their recommendations say that there is only a small benefit from starting testing at 40, and that this benefit isn't enough to outweigh potential harms of testing, including psychological harms, unnecessary biopsies, and false positives.

The task force also recommends against teaching breast self-examination, another issue that raises controversy.  Alison wrote a post a couple months ago about whether breast self exams are beneficial, take a look to get a couple more viewpoints on the issue.

The main point is that starting routine mamography at age 40 doesn't save or add years to enough women's lives to recommend screening for everyone.  But mammography does sometimes detect cancer in women in their 40s, and these recommendations have many people worried that insurance may stop covering mammograms for women under 50.  Since the task force states, "the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms," it seems unlikely that insurance companies will be able to refuse coverage for women whose physicians believe they should get earlier testing.  Women with a strong family history of breast cancer or with genetic mutations that predispose them to the disease will still be encouraged to start testing earlier.

Keep in mind that these recommendations aren't from some random group of government officials with no knowlegde of healthcare out to save money at the cost of peoples health; on the contrary, members of the task force include mostly physicians and professionals with degrees in public health and nursing from across the country.

If you want to see the details for yourself, you can take a look at the USPSTF recommendation summary itself, or articles from and the New York Times ).

Posted by on October 13, 2009 - 9:06am

You may have noticed the NFL players wearing their pink gloves and shoes for Breast Cancer Awareness Month.  But did you know that breast cancer is the leading cause of cancer-related deaths in American women?  It is caused by abnormal cell growth in the breast tissue, usually beginning in the milk-producing ducts.  The abnormal growth may spread (metastasize) through your breast to your lymph nodes, or other parts of your body.
Picture 3The most common symptom of breast cancer in both men and women is a lump in the breast, which is usually painless.  Most breast lumps are non-cancerous, but it is still important to have any lumps evaluated by a physician.  Other symptoms of breast cancer include clear or bloody discharge from the nipple, change in breast size or shape, retraction or indentation of the nipple and skin around the breast. Treatment for breast cancer often involves surgery, radiation therapy, and/or chemotherapy.  A variety of surgical techniques are available depending on the size of the lump or tumor.

The good news is there are many resources for breast cancer treatment and research at Northwestern!

The Lynn Sage Cancer Research Foundation in partnership with Northwestern Memorial Hospital and the Robert H Lurie Comprehensive Cancer Center has established the Lynn Sage Breast Cancer Program to provide women with access to the latest advances and technology in breast cancer treatment.  The center offers clinical, diagnostic, rehabilitation and counseling services at a single location.

Northwestern Memorial Hospital also offers breast reconstruction surgery for patients who have undergone lumpectomy or mastectomy or who have other cancer-related deformities.  Dr. Neil Fine, a plastic surgeon at NMH has developed an innovative technique as an alternative to total mastectomy.  The technique involves repositioning portions of the latissimus dorsi into the breast where a tumor has been removed.  Only a handful of other hospitals across the country are offering this procedure.

IWHR Highlighted Researcher
Dr. Seema A. Khan M.D., is the Bluhm Family Professor of Cancer Research at Northwestern University’s Feinberg School of Medicine.  She is also the Director of the Bluhm Family Breast Cancer Early Detection and Prevention Program at Feinberg.  She received her medical degree from Dow Medical College in Pakistan and a Master’s in Epidemiology from the Harvard School of Public Health.  Dr. Khan is a board-certified surgeon whose research interests involve prevention, early detection and treatment of breast cancer. Currently she has multiple active clinical trials including a study designed to identify biomarkers for breast cancer risk in benign breast tissue.  Similarly, she is investigating the level of estrogen in nipple fluid as a marker for breast cancer risk.  Other recent studies include the development of a topical treatment for non-invasive breast cancer and the multi-center evaluation of a preventive breast cancer therapy for post-menopausal women taking Hormone Replacement Therapy.

Other Useful Links and Resources:

Posted by on July 31, 2009 - 11:39am

CNN has posted a very interesting article about blind women in Germany who are being trained to perform breast examinations.  The program, called "Discovering Hands," is based on the theory that the blind have a keener, more sensitive sense of touch and may be able to detect small lumps that may have otherwise been overlooked.

There is some debate about the utility of breast self-examinations.  A 2001 study published by the Canadian Task Force on Preventive Health Care argued that self exams do not benefit but rather cause harm to patients.  They associated self exams with a higher incidence of physician's visits and unnecessary biopsies.  (You can access a summary of the article for free here.)

Based on my personal experience, I am an advocate of self exams.  One of my family members discovered a small lump while doing a self exam at home, which indeed turned out to be a tumor.  Luckily, it had not spread and required a lumpectomy and six weeks of radiation to remove.  In our case, there was a family history of breast cancer and my relative was vigilant about doing self exams.  Since lumpiness of the breasts varies from woman to woman and depends on the time of the month, I can see how self exams can also be confounding and unreliable.  What are your opinions on breast self-examinations?

For more information on breast self-examination:

  • A guide from the American Cancer Society
  • A guide from the Susan G. Komen Foundation