Cancer Screening Guidelines Are Difficult To Accept Last week's recommendation by a government task force, suggesting that women hold off on getting routine screening for breast cancer until age 50, continues to stir debate among advocates and those affected by the disease. For journalist Rene Syler, the debate over whether to screen or not to screen — and at what age — is a personal one.
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Cancer Screening Guidelines Are Difficult To Accept

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Cancer Screening Guidelines Are Difficult To Accept

Cancer Screening Guidelines Are Difficult To Accept

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JENNIFER LUDDEN, host:

Finally, last week's new recommendations on breast cancer screening continue to resonate. A government-appointed panel of independent experts suggested that women hold off getting regular mammograms until age 50. Yesterday, we heard Cindy Pearson, of the National Women's Health Network, explain why her group welcomes these new guidelines. Pearson says mammograms just aren't that effective for younger women. But for some breast cancer survivors, that's hard to accept. Journalist Rene Syler says the debate over whether to screen is a very personal one.

Ms. RENE SYLER (Author, "Good Enough Mother"): I recently met Stefanie Spielman, a wife, a mother and breast cancer patient battling for the fifth time. She was very frail with a warm smile and what could best be described as a peach fuzz-like mullet where her hair was just starting to grow again. Ironically, we met during breast cancer awareness month.

I thought about Stefanie and so many others last week when the U.S. Prevention Task Force announced its revamped mammography guidelines. Among their recommendations: that most women in their 40's do not need routine screening and in their 50's, a mammogram every other year is sufficient. Why? Because in women 40 to 49, only one in every 1,900 mammograms found breast cancer along with a high rate of false positives, results that would necessitate further tests and possible surgery. That number was 1 in 1,300 for women 50 and older.

The Task Force said it was also trying to alleviate the anxiety of a false positive. How about the really horrible anxiety of finding a late-stage breast cancer, one that could've been detected earlier and with better prognosis on a mammogram? The Task Force said these recommendations are for women of average risk, not for women like me. See my mother and father both had breast cancer, and that, coupled with multiple biopsies and my own breast disease, ultimately led me to choose a preventive mastectomy in 2007.

Family history is a big risk factor but it only counts for about 10 to 15 percent of breast cancer cases. The rest come right out of the blue in women of average risk. So that's why I can not fathom telling doctors not to teach women breast self-exam, which is exactly what the Task Force did. Aren't we supposed to know our own bodies, what looks wrong, feels wrong? We're supposed to know our cholesterol number, blood pressure reading. Why would we not want to know what our breasts feel like? A breast self-exam is free, it's easy and what's the harm? Tell women like Stefanie, who found her own lump in the shower that it's pointless. She was 30 years old and pregnant at the time.

The Task Force's recommendations have been almost universally decried. Kathleen Sebelius, secretary of Health and Human Services, advised women to keep doing what they're doing, as did Susan G. Komen for the Cure and the American Cancer Society. As always, and this hasn't changed, know your personal risk. Talk to your doctor and if he or she won't listen, find someone who will.

Stefanie Spielman died last Thursday leaving her husband and four children heartbroken. The Task Force and its probabilities be damned. Another breast cancer death is simply one too many.

LUDDEN: Rene Syler is author of "Good Enough Mother" and produces a video blog under the same number. Our senior producer Alicia Montgomery also has her own story. Early detection saved her mom's life and you can read Alicia's blog on our Web site at NPR.org. Just click on programs, then TELL ME MORE.

And that's our program for today. I'm Jennifer Ludden and this is TELL ME MORE from NPR News. Let's talk more tomorrow.

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