So I couldnt think of what to talk about today. That led me to think, “I wonder if there is an obscure holiday today?” and guess what? You got it. It’s National Pink Day!
So according to some research, pink was originally a neutral color not associated with sex. For a time specifically in Britain it was actually most associated with young boys, because the men in the military wore red and boys were “little men.” In the 1800s guys began to wear boring, darker, sobering colors and that’s when the ladies (always more interesting than the guys anyway) began to make pink more identifiable as a feminine color.
However, most of us love pink. It’s fun and flamboyant, and I wear it every time I speak in front of a national audience to honor my friend Dr Tom White. Pink is his favorite color. He has honored me with some great socks to go with my speaking apparel that have pink as the focal color.
So all this research has led me to my topic for today which is very high in the topic of women’s health and that is breast cancer screening.
So this isnt a fun topic but very important. Breast cancer is number 1 in women on the cancer list so it’s a very important topic. One of the difficult things about breast cancer screening is the differing recommendations from different organizations. Some docs say start screening at 40yo and some say 50. Some say screen every year and some say every other year. How’s a gal supposed to know what to do?
Well, as always, I have a lengthy detailed conversation with my pts pointing out that recommendations are for large populations, and we have to adjust them to any particular individual. I have a wife and 2 daughters so all three will need breast cancer screening as they age. So this topic is near and dear to my heart.
On an individual scale, family history is always going to be the most important factor. If my pt has even one first degree relative (first degreee means mother, sisters, daughters) with breast cancer we will, of course, be more aggressive. If there are more than one 2nd degree relative (grandma, aunt) we should probably be more aggressive.
In general, I follow the USPSTF (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening) recommendations. In short they recommend avg risk women start screening with mammogram every 2 years beginning at age 50yo and stopping at age 74yo. Once again, a woman at higher risk should discuss it with her doc and consider earlier or more frequent.
Another thing I discuss with pts is the RISK of screening. Just doing nothing has risk. But so does screening. We can actually harm you as well as help you. Docs look at the risk/benefit ratio of everything we do. It’s essentially what we do all day every day. So the main risks of breast cancer screening are repeat testing, false positive, and even unnecessary biopsies. One of my favorite websites to evaluate risk/benefit for mammogram is this one: https://www.healthdecision.org/tool#/. It actually looks at several different medical decisions, but mammo is one of them. Just fill in your info and it gives you a fun graphical representation of cancers diagnosed, lives saved, deaths, extra tests, unnecessary biopsies. You can play with screening annually v biannual v not at all.
I hope this has been a fun post for you all and brings some benefit on how you should approach breast cancer screening.
Thanks, Dr D