Caroline Calt, 43, also opted not to have mammograms. “I was afraid of the pain and what might happen. Sometimes women get a mammogram result that drives them crazy with fear for no good reason,” says the New Jersey publicist. Instead, she performed regular self-exams. “I figured that if there was a problem I’d catch it myself. Recently, I found a lump—but not soon enough.” She was diagnosed with breast cancer that had spread to a lymph node. “In hindsight, instead of trying to be my own doctor, I wish I’d faced my fears and gotten annual mammograms so the cancer would have been detected earlier.” Caroline’s case isn’t as rare


as you might think. At age 40, a woman has a 1-in-69 risk of developing breast cancer in the next 10 years, compared with a 1-in-42 risk at age 50, 1-in-29 at age 60, and 1-in-27 at age 70. Because the threat of breast cancer continues to escalate with age, over the average woman’s lifetime of 80.4 years, breast cancer risk ultimately increases to 1 in 8. In 2010, about 207,000 women in the US were diagnosed with breast cancer, and nearly 40,000 women died from the disease, which ranks as the second leading cancer killer of women, after lung cancer.


New Breast Cancer Screening Guidelines In July 2011, The American Congress of Obstetricians and Gynecologists (ACOG) issued new breast cancer screening guidelines, recommending annual


mammograms starting at age 40. ACOG previously advised mammograms every one to two years starting at age 40, and annually beginning at age 50. The organization continues to recommend annual clinical breast exams for women 40 and older and every one to three years for women ages 20 to 39. The traditional monthly breast self- exam has been replaced with a newer concept called “breast awareness”—knowing how your breasts normally look and feel. What’s behind the new


mammogram recommendations for women in their 40s? Although rates of breast cancer are lower in this age group, it’s not as rare as you might think. Every year, about 50,000 women under 50 develop the disease. “In younger women, breast cancer tends to grow faster,” reports Jennifer Griffin, MD, MPH, co- author of the guidelines. “If women in their 40s have mammograms annually, there is a greater likelihood of finding breast cancer before it has time to spread than if women wait two years between mammograms.” Breast X-rays can find breast


cancer before it causes any symptoms, adds Gerald F. Joseph, Jr, MD, ACOG’s vice president for practice activities. “By the time a breast cancer tumor becomes palpable (big enough to feel)—even by the most experienced physician, doing the most careful exam—it’s likely been there for at least two to three years and may have already spread to the lymph nodes or other parts of the body, which can be life-threatening. Mammograms


FALL / WINTER 2011 pause 23


50,000 WOMEN UNDER 50


DEVELOP BREAST CANCER


By the time women


feel a lump, it’s most likely been there two or three years


CAN DETECT NEW CHANGES IN THE BREASTS AS SMALL AS A PINHEAD


MAMMOGRAMS


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