DocSwiner's Superwoman Complex Blog

For Breast Cancer Awareness Month, here’s a timely excerpt from my new book, “The Superwoman Complex: A Follow-Up Visit.” (available on Amazon)——

Time for your check up

Taking care of yourself is an integral part of the “No Superwoman” movement. Numerous medical conditions are considered silent killers because you’d never know you had one unless a complete physical exam and lab tests revealed it. Screenings exist for that reason: to potentially catch diseases in infancy. Don’t wait until you’re on you’re deathbed to get tested for major medical conditions. Exercise preventive maintenance!

Recently, I decided to take my own advice and get an early mammogram. Though my normal breast exam, administered during a pap smear, was lump-free, my ob-gyn thought it was a reasonable idea. I also asked a good friend of mine who’s an ob-gyn and the same age what she thought about getting an early mammogram, and she’d already gotten her first one. At the time, I was 37 years old with no significant family history of breast cancer, fortunately, which generally puts me at low risk. I’d also stopped birth control pills and breastfed two babies, which also puts me at low risk. However, I was still nervous because you never know what a mammogram might reveal.

Guess what? It didn’t hurt at all! I had the new and improved 3D version, which takes a little longer but squeezes less. For my ladies who’ve worn really tight bras or breastfed, this was nothing. The tech that I had was lovely. I’m sure having a friendly technician to talk you through the procedure and laugh with you makes feel better. I asked her what the fear was with getting mammograms, and she said it had a lot to do with a patient’s anxiety level. The more afraid a woman was to get one and about what might be found, the more painful it seemed to be. She also forewarned me that since it was my first one, I would likely be called for a follow up, because there was no previous mammogram to compare it to. And she was right. I was called back for a follow up ultrasound, and thank the Lord, it was normal.

I treat female patients of all ages and I’ve diagnosed a handful of breast cancers. Some of these women had classic or textbook risks, such as being in their late 40-60s with a family history of breast cancer, or having an abnormal lump found during an exam. However, at least two or three within the last couple of years had zero risks. One that struck me as a surprise was a patient who was healthy as a horse. She was in her 30s, didn’t smoke, not on birth control and worked out all the time, but was experiencing bloody nipple discharge. As a precaution, we scheduled her for her first ultrasound and mammogram, and it was positive for cancer. I was just as astounded as she was because she looked just like me.

I’ve asked friends and family and the majority of them know someone in their 30s or 40s without any family history who has been affected by cancer. What has caused controversy is the recent change in recommendations for when to start and how often to conduct mammograms. Within the last five years the guidelines have changed, stating that we should wait until age 50 to begin mammograms, instead of starting at age 40, which I was accustomed to doing. Generally speaking, I would start conducting mammograms at age 40 and bring patients in for screening every other year. For those with significant family history, I would start at age 35. With the new guidelines, what happens to all of the 30 and 40 year olds we may miss? Needless to say, I’ve been a bit of a rebel. Maybe waiting until the early 40s is okay, but I’m definitely not waiting until age 50 to screen my patients.

Self-examination guidelines have also changed. In general, I teach all women how to examine their own breasts beginning in young adulthood. You’d think the earlier, the better applies to being comfortable with feeling your own breasts. However, with the new mammogram guidelines (USPSTF guidelines) also came the recommendation AGAINST doing self-exams. Yes, you read correctly: against. I don’t feel great about that one either, but I’m a rebel with a cause and will continue advocating early intervention. Wouldn’t you rather know than not know, and most importantly, sooner than later?

(Attached is my pic from my first mammogram. I’m standing not-so-eagerly in front of the 3D mammo machine)