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« Visualizing Empires Decline | Main | Chasing the Paliban (Sujatha) »

November 20, 2009


Thanks for the common sensical wrap up on cancer screening. I was put on the yearly mammo routine by my physicians when I turned 40. I have more or less been faithful to that schedule even though my risk level for breast cancer was deemed to be very low. I always doubted the necessity of the annual "big squeeze" for a person with my risk profile, but I went along with the recommendation because 1) my doctors insisted 2)most of my friends in my peer group were following the regimen 3)the media were full of stories promoting the benefit of a yearly screening.

While I am a bit less certain about the numerous environmental triggers for breast cancer (heredity and diet are among the two more clear correlations), I was more certain of my risk for cervical cancer. After determining that my age and lifestyle put me at a minuscule risk for the latter I now no longer plan to undergo annual pelvic exams and Pap smears. In fact I haven't had one in two years and don't plan to for at least one more. I am also seriously rethinking my next scheduled mammo coming January.

Yesterday an opinion page article in the NYT by a physician from Pennsylvania echoed the recommendations of the federal Preventive Services Task Force. Here is an opposing view.

Lots of factors contribute to breast cancer: as diverse as environmental endocrine disruptors like BisphenolA, to oral contraceptives which are in common use which raise the risk slightly, to the overall estrogen/progesterone proportions in the lifetime of a woman(dependent on a variety of factors, number of pregnancies, onset of menarche/menopause, etc.). It isn't only a function of heredity and diet.
I would rate my risk as being on the lower side, based on heredity/diet/gyne history. But factoring in the environment, water and air quality where I live, it makes sense to me to wait for a few years before going in for a mammogram.
The opposing view in the NYT article cites congresswomen who have been on the opposite sides of the abortion debate. It's amazing that they share common ground over mammaries, unlike uteri;)

the alarming increase of incidence of breast cancer in kerala has become a subject ofdiscussion here. one in eight is the latest stats. absolutely scary.
i thought US was thinking of replacing mammo with MRI cos the former is not dependable. nothing being done in that direction?

As of now, the recommendations still focus on mammography.
MRIs are still considered experimental to diagnose certain types of breast cancer.
"In women with a high inherited risk of breast cancer, screening trials of MRI breast scans have shown that MRI is more sensitive than mammography for finding breast tumors. It is common for MRI breast scan results to appear abnormal even though no cancer is present. Screening studies of breast MRI in women at high inherited risk are ongoing."

Has anyone looked into environmental factors in Kerala, or possibly toxins ingested via seafood, since that is an important protein component in the Keralite diet?

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