October is breast cancer awareness month, and this year, there is some good news to report. According to the American Cancer Society, breast cancer deaths were down 39% between 1989 and 2015. This is attributed to improvements in screening as well as treatment. Successfully treating breast cancer means that more women, 3.5 million in the U.S., are now living with and beyond their breast cancer diagnosis. This is, indeed, good news!

Still, 1-in-8 American women will develop breast cancer during her lifetime. Since finding breast cancer early is the key to successful treatment, and mammography is one of the best tools in the box, October is a great time to remind women to have a mammogram if they are due for one.

Determining whether you are “due” for a mammogram, however, is not as straightforward as it used to be. To help me sift through the varying recommendations of ACOG, USPSTF, the American Cancer Society, and so on, I spoke to my friend Carolyn Wyatt, Women’s Health Nurse Practitioner at Care for Her at Mendocino Community Health Clinics.

“Yes, it has become more confusing” Carolyn tells me. How often to have a mammogram has become more of a participatory decision between patient and provider based on three factors: 1) personal risk, 2) comfort level, and 3) provider recommendation.
To assess personal risk, Carolyn told me about a handy online tool that any woman over 35 can use to calculate her personal risk for breast cancer and determine whether it is statistically above or below average for age. The web address is cancer.gov/bcrisktool. This simple test consists of eight questions, which taken together, provide a woman with both a five-year and lifetime risk of breast cancer, compared to average risk for a woman of the same age. If a woman’s risk is above average, more frequent screening, and beginning at an earlier age, could be considered.

Comfort level is more subjective. Carolyn says, “if a woman rests better at night by having a mammogram every year, then she should have one every year.” Some women, regardless of whether they are above or below average risk for breast cancer, will have more peace of mind by maintaining an annual mammography schedule.

It is important to note that the American College of Obstetricians and Gynecologists (ACOG) still recommends annual mammograms, beginning at 40 and continuing through age 74. The CDC website has a good side-by-side comparison of the mammogram screening guidelines of seven different professional organizations and public interest groups. This can be found by going to cdc.gov, and navigating to the breast cancer information page. Or, simply search “breast cancer screening guidelines” and choose the CDC website PDF document.
Of critical importance to finding breast cancer early, Carolyn emphasizes, is a woman’s personal familiarity with her own breasts—knowing what they look and feel like day-to-day, month-to-month. Any change in appearance, skin color, firmness, indentation, discharge, really anything out of the ordinary, should be checked out. Learning to do breast self-exam, and to do it thoroughly and correctly, makes every woman her own best defender against breast cancer.

The Cancer Resource Centers’ 2017 Cancer Awareness and prevention series is sponsored by CRC in collaboration with the Mendocino County Health and Human Services Agency. The information presented is for educational purposes and is not intended to replace the advice of your health care provider. We encourage you to discuss any questions or concerns you may have with your health care provider. The Cancer Resource Centers of Mendocino County is a grassroots organization serving our communities since 1995 by providing information, advocacy, and support services free of charge.

Karen Oslund

Executive Director
Cancer Resource Centers of Mendocino County
karen@crcmendocino.org