Dr. Marisa Weiss scheduled her mammogram this spring, just as she does every year. She had just turned 51, and after having annual scans for a decade, she knew what to expect: her dense breast tissue made reading the films difficult \u2014 \u201clike looking for a polar bear in a blizzard\u201d \u2014 and the technician would probably ask her to sit for a few extra views. <\/p>\n
This year was different. After Dr. Weiss went home, she got a call from the doctor\u2019s office. <\/p>\n
\u201cThey said, \u2018Can you come back, now?\u2019 \u201d she recalled. \u201cI said I\u2019d prefer not to, and they said, \u2018Are you sure?\u2019 And I realized at that moment that it was more serious.\u201d <\/p>\n
Dr. Weiss, who soon learned that she had an invasive Stage 1 cancer in her left breast, is not just any physician. A radiation oncologist and a specialist in breast cancer, she founded a popular Web site, breastcancer.org, for women seeking comprehensive information about the disease, and she considers herself a woman with a mission. She sees patients three days a week, but she devotes four days a week to the site, which draws millions of visitors from 250 countries each year. She is writing her third book on breast cancer for a general audience. <\/p>\n <\/strong>A year ago, when a federal task force issued new category_idelines relaxing the recommendations for mammography screening, Dr. Weiss was one of their fiercest critics. Mammograms aren\u2019t perfect, she said at the time, but they save lives. Now she says one may have saved hers. <\/p>\n <\/strong>In the annals of medicine, Dr. Weiss\u2019s story is just that: a story, an individual experience of the kind scientists dismiss as anecdotal, no reason to rethink policy. But it underscores the lingering, uncomfortable questions about when and how often to undergo breast cancer screening, and how to balance the benefits of early diagnosis with the harms of mammography \u2014 including false positive results that can lead to unnecessary biopsies and overtreatment. <\/p>\n <\/strong>The new category_idelines call for postponing routine screening for women at average risk to age 50, from 40, and recommend scans every other year instead of every year. <\/p>\n If Dr. Weiss had followed them, she might have skipped this year\u2019s scan, giving the tumor more time to grow undetected; and if she had not had a trail of scans from her 40s, doctors would not have been able to compare the images and notice the tumor\u2019s subtle emergence. (In fact, her risk is above average, because of her dense breast tissue and a family history. But she noted, \u201cMost women who get breast cancer don\u2019t have a family history \u2014 that\u2019s a huge myth.\u201d) <\/p>\n <\/strong>Yet even at the American Cancer Society, which continues to advise women to start regular mammograms at 40, experts acknowledge the limitations of screening. <\/p>\n <\/strong>\u201cMost people think mammography is much more beneficial than it actually is,\u201d said Dr. Otis Brawley, the society\u2019s chief medical officer. \u201cEven if you take the most liberal, most pro-mammogram argument, we need something better.\u201d <\/p>\n Dr. Brawley says that on balance, mammography saves lives. But he notes that it misses some cancers, and that radiation from the scans will actually cause some cancers to develop. <\/p>\n In addition, some women will be called back repeatedly for additional procedures, scans and biopsies that ultimately rule out cancer but can be painful and anxiety-provoking. Mammograms also find some cancers that grow very slowly but look the same as any other cancerous tumor, leading to aggressive but unnecessary treatment. <\/p>\n The United States Preventive Services Task Force found that while mammograms saved lives over all \u2014 reducing the breast cancer death rate by 15 percent \u2014 the benefits fell off rapidly for younger women, who also bore the greatest burden of the harms. While one cancer death is prevented for every 1,339 women in their 50s and every 377 women in their 60s who undergo screening, 1,904 women in their 40s would need to be screened for 10 years to prevent a single cancer death. <\/p>\n The panel also discouraged breast self-exams and even physicians\u2019 breast exams. <\/p>\n But though the recommendations received saturation coverage in the news media last year, little attention was given a month later, when the panel modified its message. Concerned that it had been misunderstood, the panel took the extraordinary step of amending the standard language of its recommendations and removed the critical word \u201cagainst\u201d as applied to routine mammography of women in their 40s. <\/p>\n It let stand the language recommending that the decision to start screening every other year \u201cshould be an individual one\u201d that \u201ctakes patient context into account, including the patient\u2019s values regarding the specific benefits and harms.\u201d <\/p>\n \u201cNo one had read that second sentence \u2014 no one got beyond the words \u2018recommend against\u2019 routine screening in women 40 to 49,\u201d said Dr. Bruce Ned Calonge, chairman of the task force, in a recent interview. \u201cWe didn\u2019t say, \u2018Don\u2019t screen.\u2019 The intent of the task force was to promote shared decision-making between physicians and women in that age interval.\u201d <\/p>\n <\/strong>There are already some indications that primary-care doctors are cutting back on mammography referrals. A recent report by the Centers for Disease Control and Prevention said a third of breast cancer cases were diagnosed at late stages, when treatment is more difficult. <\/p>\n The trend is disturbing to Dr. Weiss, who says she fears that radical changes in the way women live \u2014 earlier puberty, rising obesity and alcohol consumption, environmental pollution, long-term use of oral contraceptives, later childbearing and less breast-feeding \u2014 could lead to more breast cancer emerging at younger ages. <\/p>\n Her own surgery went well. She did not need radiation or chemotherapy, because the cancer had not spread. She began hormone therapy and was soon back to her crowded full-time schedule. <\/p>\n Dr. Weiss, who lives in Wynnewood, Pa., has made some lifestyle changes since her diagnosis \u2014 filtering her tap water, no longer cooking in plastic, and buying hormone-free meat and organic fruit. She lost 15 pounds and became a Zumba dance-exercise enthusiast. She eats lots of leafy green vegetables, has cut down on wine and always tries to get a good night\u2019s sleep. <\/p>\n <\/em><\/strong>\u201cI\u2019m sharing my story in order to encourage women to step forward and get that mammogram,\u201d she said. \u201cI\u2019m lucky to have caught this early, and I want to use my situation as an example of the value of early detection. <\/p>\n <\/em><\/strong>\u201cThe thing is: every woman is at risk. And every woman needs to do everything she can to protect herself.\u201d<\/strong> Dr. Marisa Weiss scheduled her mammogram this spring, just as she does every year. She had just turned 51, and<\/p>\n","protected":false},"author":1213,"featured_media":72448,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"colormag_page_container_layout":"default_layout","colormag_page_sidebar_layout":"default_layout","footnotes":""},"categories":[],"tags":[],"class_list":["post-7016","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"magazineBlocksPostFeaturedMedia":{"thumbnail":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u-113x150.jpg","medium":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","medium_large":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","large":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","1536x1536":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","2048x2048":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-highlighted-post":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-featured-post-medium":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-featured-post-small":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u-113x90.jpg","colormag-featured-image":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-default-news":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u-113x150.jpg","colormag-featured-image-large":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-elementor-block-extra-large-thumbnail":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-elementor-grid-large-thumbnail":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-elementor-grid-small-thumbnail":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg","colormag-elementor-grid-medium-large-thumbnail":"https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg"},"magazineBlocksPostAuthor":{"name":"Joshua","avatar":"https:\/\/secure.gravatar.com\/avatar\/62ee23f8f40307578d1f284ecd823d77f32da8ea35541e7dbdafeb5da1a4e877?s=96&d=mm&r=g"},"magazineBlocksPostCommentsNumber":"2","magazineBlocksPostExcerpt":"Dr. Marisa Weiss scheduled her mammogram this spring, just as she does every year. She had just turned 51, and","magazineBlocksPostCategories":[],"magazineBlocksPostViewCount":189,"magazineBlocksPostReadTime":6,"magazine_blocks_featured_image_url":{"full":["https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg",113,170,false],"medium":["https:\/\/asiancemagazine.com\/wp-content\/uploads\/u.jpg",113,170,false],"thumbnail":["https:\/\/asiancemagazine.com\/wp-content\/uploads\/u-113x150.jpg",113,150,true]},"magazine_blocks_author":{"display_name":"Joshua","author_link":"https:\/\/asiancemagazine.com\/?author=1213"},"magazine_blocks_comment":2,"magazine_blocks_author_image":"https:\/\/secure.gravatar.com\/avatar\/62ee23f8f40307578d1f284ecd823d77f32da8ea35541e7dbdafeb5da1a4e877?s=96&d=mm&r=g","magazine_blocks_category":"","_links":{"self":[{"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=\/wp\/v2\/posts\/7016","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=\/wp\/v2\/users\/1213"}],"replies":[{"embeddable":true,"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7016"}],"version-history":[{"count":0,"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=\/wp\/v2\/posts\/7016\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=\/wp\/v2\/media\/72448"}],"wp:attachment":[{"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7016"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7016"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/asiancemagazine.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7016"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\n<\/p>\n","protected":false},"excerpt":{"rendered":"