What I wish I’d known about early detection:

• I was at risk. I didn't think it could happen to me, because I was so healthy and did everything I knew to reduce my risk. I was a health and fitness professional for 23 years at the time, doing everything"right". If you are a woman and you are getting older, you are at risk. Seventy percent of the time there are no identifiable risk factors!!!

• That SBE (self breast exam) and CBE (clinical breast exam) are even more vital for a woman with dense breasts. Without a mass to examine, or other identified concern a doctor might see on a mammogram, routine ultrasound or other imaging is not conducted. I thought a mammogram was enough.

• Regular, annual mammograms are vital for detecting small changes that might indicate tumor growth (like calcifications in unusual shapes and sizes). Avoid skipping years or changing facilities without bringing your prior films.

• Film mammography sensitivity is only 30-55% for women with dense breasts. Digital mammography takes it up to 70% in a best case scenario (quality equipment, operator, and interpreting radiologist), but that still leaves 30% or greater where cancers can be missed (in women with dense breasts).

• Ultrasound has proven to increase the number of cancers detected by 67-100% in studies at single institutions. In addition, small invasive cancers have been found with this technology, usually before the cancer has spread to the lymph nodes. But remember, in most centers you must have an identified area of concern before ultrasound would be done; hence the need for SBE, CBE, and RAM (regular, annual mammograms).

For more information and a Q & A about breast density, click on
breast cancer facts to the left.

I devised acronyms to help you remember to take action with SCRAM exams© and to be FEISTY© with your actions!!

SCRAM exams©
S self-breast exam, monthly
C clinical exam by your doctor, yearly
RAM regular, annual mammograms after 40-don't skip a year

And
if you have a lump, or other identified concern, be FEISTY© with your actions.
F follow-up and
E evaluate
I imaging (further imaging)
S surgeon (with a breast surgeon when possible)
T trust…
Y YOUR intuition!

A special thanks to Wendie Berg, MD, PhD, FACR, Breast Imaging Consultant and Study Chair for the American College of Radiology Imaging Network (ACRIN) Protocol on Screening Breast Ultrasound, for reviewing the material presented for content and accuracy

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