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Jay K. Harness, MD: No, no, no, no, no you need to be doing a breast self-exam because
as Cathy Cole knows and I think you know as well, the vast majority of patients that come
see me with breast cancer don’t have… Yeah, Cathy, jump in here with some of the myths
that as a breast cancer nurse navigator you’ve heard these stories like I have thousand times.
Cathy Cole: Oh so many, this one in particular - 'If I have no family history, I don’t
have to worry’ and over 80% of all women who develop breast cancer have no family history
and less than five percent of families actually carry the BRC gene. So does it really make
any women at low risk that can avoid doing this proactive procedure? No, everyone is
sort of responsible to their own health and that means breast exams for all and mammograms
after 40. I hear a lot of things about bras causing breast cancer, deodorants – all
kinds of things that really have nothing in the evidence-based medicine to support that
these cause cancer. We always want to look for a reason for everything but sometimes
it’s a random, unfortunate occurrence and we just have to catch it at its early stages
Jay K. Harness, MD: As you know, we have federal panels put together talking about how often
should we have mammograms. We’ve got all sorts of different groups ‘oh my golly,
there’s no value to this’. ‘Oh we’ve got some prospective trials that have been
done – some famous ones outside of the United States that did not show a lower death rate
by doing breast self-exam’ because then a tendency for even clinicians frankly, not
to perform a clinical exam by the physicians and maybe sort of pulling, if you will, the
whole breast self-examination concept, and I personally feel that nothing could be farther
from the truth and while we don’t have good prospective trials to show ‘oh gosh, this
is lower than the certain percentage and we are very cost-conscious now’, and ‘oh
my golly, it’s going to lead to more mammograms and more ultrasound and more healthcare costs’.
Cathy, I think we needed to jump in with this one because there are people out there watching
today who have heard these stories and say ‘oh gosh, we don’t need to do it’, I
think it’s just critically important. It’s all part of the early detection of
breast cancer, which in fact does lower death rates. Do you want to comment?
Cathy Cole: I agree and I think on behalf of the NCBC and all of the experts that join
us every year at our national conference, the overwhelming thoughts are that mammograms
should start at 40. They need to be done yearly and despite all the other studies that
have been done around the world that don’t show any benefit of breast self-examination,
we couldn’t be more proactive for men and women of the appropriate age in the 20s and
making this a health habit that this does in fact lead people to their clinicians for
evaluation when they find something. To deny this is just looking for trouble and finding
cancers at a later stage which doesn’t save money. It’s not cost-effective and it
doesn’t help the patient in the long run with survival. So I agree with you whole-heartedly
Jay on this.