Ignore the US Preventive Service Task Force Recommendations

It is important that all women in this country ignore the recent US Preventive Service Task Force recommendations regarding breast cancer and mammograms. They are totally wrong and incompetent.

I treated breast cancer for thirty years. It is treacherous, devastating and deadly. It is important to do everything possible to detect and eliminate it as early as possible. When detected it must be treated aggressively. At the time of detection the cancer is systemic, i.e., spread throughout the body so that chemotherapy will be necessary along with (1) lumpectomy and radiation or (2) surgical radical mastectomy.

Get mammograms every year starting at age 40. Start sooner if you have a family history of breast cancer. Breast cancer has a nasty habit of appearing earlier in younger members of a family with a positive family history. If grandmother had it at 70, mother can have it at 50 and you can have it at 30. Don't hesitate. The mammogram is your best defense.

A Hard and Fast Rule: lumps or masses in the breast must come out and be put under the microscope. No exceptions. The doctors cannot tell by examination, needle biopsies can miss, and the mammogram is not perfect in excluding cancer. The microscope is the gold standard.
Find a good surgical oncologist and work closely and repeatedly with him/her.

If you have a strong family history; mother, two sisters and three cousins with breast cancer, consider having bilateral subcutaneous mastectomies now. The nipple and skin can be preserved and implants put in to match your expectations of size, shape and uplift. If there is history of duct cell cancer the nipples must be watched closely so you still have to be checked every year or if there is a change in the nipple. The removed breast tissue must be thoroughly studied under the microscope. If there is cancer it is better to remove the skin that would overlie the breast along with the nipple and lymph nodes. If there is no cancer, you are as well protected as is possible.

A lump of cancer in the breast presents three problems; (1) the cancer mass itself, (2) floating cancer cells in the fatty tissue surrounding the breast and in the skin and (3) cancer cells in the lymph nodes between the muscles and near the collar bone. Lumpectomy gets the tumor mass and radiation can be given to the chest wall muscles and collar bone area. Late effects of radiation are dense scarring, blood shot skin and a hard breast. Radical mastectomy surgery removes the breast containing the tumor mass, the skin and fat from the chest wall and the lymph nodes between the muscles and near the collar bone. Surgery leaves a flat chest, a long scar and danger of swelling in the arm. Neither method leaves a pretty and normal looking breast. The effort here is to stop the cancer and save a life.
Do not minimize the threat of this disease to life.