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Wayne Independent - Honesdale, PA
  • Know thyself: While self exams aren't a recommendation, knowing your breasts is key

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  • Cancer runs in Jo Galfi’s family, so the working mother of four knew the importance of early detection. Lung cancer took her mother, and her sister was diagnosed with breast cancer at age 34 and again shortly after her fifth year “all clear” appointment. Her grandmother and an aunt also had breast cancer.
    In January 2005, Galfi was a physically fit, live-life-to-the-fullest type of person working as a secretary in the counselor’s office at West Leyden High School in the Chicago suburbs. She was 47 when she found a lump in her breast.
    “I was working out at the time and thought it may be a pulled muscle or something, but it didn’t hurt. I waited a while to see if it would go away by itself, but I couldn’t stop thinking about it,” Galfi said.
    She made a doctor’s appointment a short while later.
    “The biopsy came back as malignant, and surgery was scheduled for March 15. I was a bit worried — the Ides of March!” Galfi said.
    A mammogram only a few months before showed nothing suspicious.
    “I found the lump through a self-exam. I believe the self-exam worked,” Galfi said. “Since cancer runs in my family, I was always checking. Early detection is so important.”
    Registered nurse Stephanie Martin, a patient navigator at Cancer Wellness at Piedmont Newnan Hospital outside of Atlanta said, “Breast self-exam absolutely does still matter. It is not encouraged or discouraged by the American Cancer Society, but it certainly is important for an individual to be familiar enough with their own body to notice if something changes.”
    Updated recommendations
    It may be surprising, especially to women who grew up practicing breast self-exams, that they are not recommended by many major cancer organizations, such as Susan G. Komen, the United States’ largest breast cancer organization, according to its website.
    Additionally, “in 2009, the U.S. Preventive Services Task Force recommended against teaching breast self-exams,” said Debbie Saslow, director of breast and gynecologic cancers for the American Cancer Society. “That is their current guideline. The 2007 American Cancer Society guidelines recommended that women be aware of what their breasts normally look and feel like and promptly report any changes such as a lump to a (health care) provider.
    “Often women who detect a lump or other breast change do so during their everyday activities when showering or dressing and not during a formal breast exam.”
    Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine in Nashville, Tenn., said that “self-exams in the past have not proven to be very effective” in finding breast cancer.
    Page 2 of 2 - “Obviously, if you feel a lump that concerns you, you should have it examined, but the problem is that small tumors are often not found even by trained physicians. This is one area where the technology — mammograms — have superseded what physicians can do on their own,” Schaffner said.
    Before today’s technology, self-exams “were all we had,” Schaffner said. In the ‘70s during the heyday of the women’s health movement, breast self-exams were seen as a simple, low-tech way to check lumps that could possibly be breast cancer. Times have changed, though, as studies revealed that self-checks led to more imaging procedures and biopsies but did not reduce cancer deaths, Schaffner said.
    “The problem (with self breast exams) is that by the time a woman can feel a lump or notice a change, it has been there for quite some time — several years longer than a mammogram would detect it,” Saslow said. “What is recommended is annual mammograms starting at age 40 and awareness of what is normal with prompt medical attention when a change is found.”
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