First, a disclaimer: I’ve never done regular breast self-exams. I tried it once, twice at most, in the late ’80s or early ’90s. I brought home a little how-to tag and hung it on my bathroom door for about three weeks before I threw it away. I figured I’m more likely to notice something in the shower. (And now that I’m on the cancer watch list for my remaining breast, I get four exams a year, courtesy of twice-yearly visits with my oncologist and family doctor. So I’m good in the exam department.)
The problem with breast self-exams is that by the time you can feel something, breast cancer has gotten a pretty big head start. And if you’re young, it’s even bigger. The American Cancer Society says breast self-exams don’t work as well for young women, since their breast cancer is likely to be dense and more able to hide tumors. They discuss the pros and cons of BSEs in their guidelines for early detection.
Some groups, such as the Feel Your Boobies Foundation, which is geared to young women (and some would argue, young men), advocate BSEs. I’m not sure I can fault them for that, for the simple reason that young women seem to have no screening alternatives. You can get a genetic test for BRCA and/or a mammogram if you have a family history. But, as the American Cancer Society says, only 5 to 10 percent of breast cancer cases are hereditary.
So where does this leave young women? They’re too young for mammograms. Another screening tool coming into wider play is the MRI, but they’re recommended only for women at high risk and therefore not indicated for young women without a family history. And they’re pricey, to boot. Mine cost $4,000.
The only option young women seem to be left with is finding a lump and treating cancer that has progressed far enough to produce one. By that time, you’re talking heavy artillery like chemo.
I know this is what health experts call anecdotal, meaning it’s based on my own observations and not scientifically sound data, but I’ve never met a woman in her 30s who was diagnosed with stage 0 breast cancer. The only ones I’ve ever met are stage III or IV. It seems to be the women my age (55) and older who are stage 0 and stage 1. And we’re the ones getting mammograms and MRIs.
I think every woman should know what’s normal for her breasts, just as she should know her entire body, and report any changes to her doctor. But BSEs seem a bit too little, too late as a screening tool. I wish I had an answer, but all I have are questions. All I know is there seems to be nothing out there for young women. Please, someone tell me I’m wrong.