A recent announcement by a US government task force recommending against regular mammography tests for women in their 40’s is raising some very skeptical eyebrows. For years and years, we have heard doctors preach about the importance of regular breast cancer screenings after the age of 40. But according to the Preventive Services Task Force of the Department of Health and Human Services, a government panel of scientists and doctors in the field, screenings starting in a women’s 40’s lead to unwarranted cancer scares and costly, unnecessary biopsies that have little effect on improving a woman’s odds of survival. The task force’s official recommendation is for women 50 and older (not 40 and older as previous recommended) to get a mammography test every other year (not once a year as previously recommended).
Critics of the new recommendation include the American Cancer Society, who just released a statement advocating regular breast cancer screenings, and a number of breast cancer survivors, particularly those who were diagnosed at an early age. Accusations have been made that this recommendation is a product of government “rationing” to cut costs in preparation of the proposed universal health care plan.
The sentiments of the American Cancer Society are summed up in this statement released by Otis W. Brawley, M.D., chief medical officer of ACS:
“The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider… like the USPSTF, the American Cancer Society panel also found that mammography has limitations…But the limitations do not change the fact that breast cancer screening using mammography starting at age 40 saves lives.”
As a cosmetic and reconstructive surgeon with a special interest in breast reconstructions, I have to wholeheartedly agree with the American Cancer Society in their recommendation to continue annual breast cancer screenings after the age of 40. I have seen so many women come through my offices after successfully battling the breast cancer disease, many of them in their 40’s, and if an annual mammography contributed to saving even one of their lives, then it is worth it. As with most cancers, early detection is the key to survival. Even if mammograms at an early age lead to unnecessary biopsies, they also lead to early cancer detection – and that is the most important thing.
Dr. Whiteman is medical director and board member of The Sport of Giving, a nonprofit organization dedicated to cancer care and prevention for woman in local communities. Visit the Southern Plastic Surgery website to learn more about breast reconstructions, Dr. Whiteman’s breast cancer buddy system, and his involvement in the Sport of Giving.
Breast Cancer surgery can be one of the most devastating experiences in a woman’s life. Not only are patients exhausted from their battle with cancer and worried about their future, but a mastectomy (the surgical removal of one or both breasts) can leave a woman feeling less like her old self than ever before. That is why a new statistic by the American Society of Plastic Surgeons came as such a shock: nearly 70 percent of women eligible for breast reconstruction after a mastectomy are not informed of the surgical options available to them.
The difference in those seeking reconstruction and those who did not was most apparent when comparing different racial and ethnic groups. In another study by the University of Michigan Comprehensive Cancer Center Latina who spoke limited English were less likely to undergo reconstruction than white women, black women, and English speaking Latina women. While 41 percent of white women and English speaking Latina women underwent reconstruction, only 14 percent of less acculturated Latinas did. Because of the language barrier that exists between patient and doctor, patients who spoke limited English were less informed of their options.
In fact, a related study showed that women who were simply referred to a reconstruction doctor during their breast cancer surgery were much more likely to undergo the procedure. In the ACS Clinical Congress study, 92 percent of patients who were referred underwent reconstruction and none of the non-referred patients underwent the surgery!
The statistics above show how much a little information can do to help a patient realize their recovery options. That is why new technology is emerging to help patients become more aware of their options. For instance, there is a computer based decision making aid on the market right now that teaches patients their various reconstruction options. According to a study conducted at Beth Israel Deaconess Medical Center and Harvard Medical School, women who used the CD learning module were more involved in choosing reconstruction than those who did not, and they believed they were offered a greater number of surgical options for breast reconstruction – once again highlighting how empowering information can be.
The bottom line is that all women should be informed of all of their options from the onset of their breast cancer diagnosis. Whether or not a woman chooses to undergo breast reconstruction after a mastectomy is a personal decision – yet every woman deserves the right to make that decision.
It is important to present plastic surgery as an option from the onset of treatment; that way, doctors can work together every step of the way to give a patient the best possible treatment. In fact, many patients choose to have their breasts reconstructed during the same time as their mastectomy to reduce the number of surgeries needed.
Education is only one of the ways to make the battle against breast cancer more bearable; that is why Dr. Whiteman developed a “buddy system” in the offices of Southern Plastic Surgery. His support program gives breast cancer patients the option to speak with other survivors to gain a better understanding of what to expect from their surgery.
All of us are guilty of getting the catchy song about our “bologna’s first name” stuck in our head and have memories of getting overly giddy when we saw the infamous Weiner Mobile cruising down the streets of our town. These reminiscent childhood memories are what sparked Dr. Whiteman and his wife Sheri to bid on a stuffed replica of the Weiner Mobile at this year’s Sport of Giving Silent Auction at their annual Pink Party. To their delight – they won! – and along with it, a ride on one of Oscar Meyer’s hotdog shaped vehicles. While this experience might have been a childhood dream come true, the purpose of the auction (and the exciting items that guests were able to bid on) was to make women’s dreams of cancer recovery come true. Dr. Whiteman serves on the board of directors of the Sport of Giving, a 501(c)3, nonprofit organization that raises money in support of breast cancer care and prevention in the Atlanta community. As spokesperson and medical advisor of the Sport of Giving, the breast cancer cause is very close to Dr. Whiteman’s heart. He dedicates himself to breast cancer research and education – performing breast reconstructions, devoting his time to regularly counsel breast cancer patients, and speaking to various hospitals and associations. To find out more about the fun and exciting events that the Sport of Giving hosts and ways you can get involved, visit www.sportofgiving.com.
“… and when they ask me why I say, Cause Oscar Mayer has a way with B-O-L-O-G-N-A!”