The nice thing about blogging is that I can have an opinion and express it as such. This may be in direct contrast to the official 'recommendations' of the medical establishment.
A case in point are the new mammogram recommendations. Last year someone who was writing an article for 'Good Housekeeping' called me and asked how the new recommendations would change my practice. I told her honestly, they wouldn't.
My response must have been either uninteresting or not politically correct as it wasnt published!
Now that Breast Health awareness month is back (October) I get asked this question again quite a bit.
As far as I'm concerned the new recommendations dont make sense and I believe if my patients see the facts they will agree.
Some of the most egregious recommendations include: discouraging women from doing their own self breast exam and not starting mammograms until the age of 50. Do these jokers know how many of my patients would have been dead by now if I followed these recommendations?
While glancing through a recent edition of Family Practice News I noticed a reference to a study done in Michigan, with more than 5000 women, which agrees with me. The study was reported at the symposium of the American Society of Clinical Oncology. It found that many breast cancer patients would have more advanced disease and face harsher treatment if the recently updated screening guidelines of the US Preventive Services Task Force were widely adopted.
In women under 50, 48.3% of breast cancers were detected by mammography, 46% by palpation.
The speaker concluded that " you are better off if you can have your cancer detected by mammography .....you will have more options and likely need less aggressive treatment......we would support the societies that continue to recommend annual screening mammography starting at age 40"
Do not misunderstand me, mammograms are not perfect and there is some radiation exposure but if you have breast cancer they definitely beat the alternative! I think if you are under 50 you can work it where you can get more thermograms and less mammograms but you still need to get that baseline mammogram to know where you stand. They dont hurt anymore and can be life saving.
Breast cancer treatment has come a long way but we still have a long way to go to eradicate the disease.
Prevention is ALWAYS better than cure.
Stay Well
Dr Tuakli
Showing posts with label thermograms. Show all posts
Showing posts with label thermograms. Show all posts
Sunday, October 30, 2011
Sunday, January 3, 2010
Latest mammogram recommendations
I have been asked by some patients what my thoughts are regarding the new mammogram recommendations. Quite frankly they don't make sense to me and will not change my current management of patients at all. Why?
Well first of all they are exactly what they claim to be "guidelines", I can choose to follow them or not. In this case I would rather not.
Mammograms are problematic from the standpoint of radiation however I have seen MANY patients diagnosed with Breast Cancer as a result of them. One of the most concerning trends has been the discovery of breast cancer in younger and younger women, the idea that they would not be diagnosed because they would delay their mammograms to the age of 50 is scary.
The bottom line is, as with most things in medicine, tailor the recommendation to the patient. It is important to have an on going relationship with a physician who knows you and who will make recommendations based on his or her knowledge of you and your particular situation, not based on guidelines. For example prolonged use of certain contraceptives, family history, breast exam findings are all things that would change how often and when a particular patient should get a mammogram.
Remember guidelines come and go, they are not set in stone and neither is your wellness. It should be a dynamic process arrived at by rational thinking and on going education.
When insurance companies finally start paying for thermograms we will have alternatives that don't involve radiation that may be more appropriate for some patients.
Until then for most people mammograms are the best they can afford ......
If you are at high risk remember to avoid caffeine, take indole-3, do regular self breast exams, do not take Provera and follow your doctors screening schedule.
Wishing you a healthful 2010
Dr Tuakli
Well first of all they are exactly what they claim to be "guidelines", I can choose to follow them or not. In this case I would rather not.
Mammograms are problematic from the standpoint of radiation however I have seen MANY patients diagnosed with Breast Cancer as a result of them. One of the most concerning trends has been the discovery of breast cancer in younger and younger women, the idea that they would not be diagnosed because they would delay their mammograms to the age of 50 is scary.
The bottom line is, as with most things in medicine, tailor the recommendation to the patient. It is important to have an on going relationship with a physician who knows you and who will make recommendations based on his or her knowledge of you and your particular situation, not based on guidelines. For example prolonged use of certain contraceptives, family history, breast exam findings are all things that would change how often and when a particular patient should get a mammogram.
Remember guidelines come and go, they are not set in stone and neither is your wellness. It should be a dynamic process arrived at by rational thinking and on going education.
When insurance companies finally start paying for thermograms we will have alternatives that don't involve radiation that may be more appropriate for some patients.
Until then for most people mammograms are the best they can afford ......
If you are at high risk remember to avoid caffeine, take indole-3, do regular self breast exams, do not take Provera and follow your doctors screening schedule.
Wishing you a healthful 2010
Dr Tuakli
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