Wednesday, September 8, 2010

Know your body!

I've had this ongoing conversation with one of my coworkers recently. She is preparing to teach a evidence based course on preventive health. This course will cover things like flu shots, colonoscopy and mammograms guidelines, etc... The United States has a Preventive Service Task force that offers guidelines based strictly on evidence, and obviously - health care costs. They have released some new guidelines surrounding mammograms and self breast exams, which I think I have blogged about before.

The US Preventive Services Task force statements:
"The USPSTF concludes that the evidence is insufficient to recommend for or against teaching or performing routine breast self-examination (BSE)."
and
"Clinicians who advise women to perform BSE or who perform routine CBE to screen for breast cancer should understand that there is currently insufficient evidence to determine whether these practices affect breast cancer mortality, and that they are likely to increase the incidence of clinical assessments and biopsies."

So they are saying that if we teach women to do self exams, they may find non-cancerous lumps and go to the doctor to rule out breast cancer and this would increase medical costs. I do want to add that there was NOT an oncologist or breast surgeon on the panel. To me, that is like changing the cardiovascular guidelines without a cardiologist on the panel. In response to their guidelines Komen, American Cancer and others have issued their own statements contradicting some of their recommendations.

My advice to her on this training is to present the evidence based findings, and then stress to coaches to teach people to KNOW their bodies! Know how your breast feel, know how your skin looks, know if there is a change in your bowel or bladder habits, know if your voice changes octaves, or your throat is always scratchy and if there is any change - report these to your doctor immediately!

I was not really doing a self breast exam when I found my lump two years ago. I was simply enjoying some new body wash and washing my chest when I thought, hmm...what was that? that lump hasn't been there before! So, if I had waited until my routine mammogram (which according to the task force would not be due for another 7 years); I would have most likely had metastatic triple negative breast cancer, instead of catching it at stage 1.

So my advice is KNOW your body and report any changes!

Thoughts/video from a physician:
http://www.medscape.com/viewarticle/727549?src=emailthis

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