Tahoe doctor is proof breast exams save lives

By Kelly Shanahan

I guess I am the woman whose life would be considered expendable under the U.S. Preventive Services Task Force’s new guidelines on mammography screening and breast self exam.

I guess Caroline, the 26-year-old medical student who sat next to me as we both got chemotherapy; and Linda, the ward clerk at my little hospital; and Melodie, the restaurant owner — all of whom felt their cancerous lumps on breast self exam — are expendable as well. I guess my patients and fellow breast cancer survivors Lisa, Karen, Marla, Chris, Carolyn, Tracey, Annette, Michelle, Jana, Diane, Alice, Shelley, Anne, Kelly, Pam, Carol, Rebecca, Suzanne and Lea — all of us diagnosed with breast cancer prior to age 50 — are unimportant.

I understand many women under 50 (1,904) will need to be screened to find one woman with breast cancer. I understand that this costs money. But breast cancers diagnosed in women in their 40s are often more aggressive, faster growing tumors, and finding these cancers earlier unequivocally saves lives. Even the USPSFT, in the same paper recommending stopping mammograms in women in their 40s, acknowledges a 15 percent reduction in the death rate in women between ages 40 — 50 who have regular mammograms. Finding cancer earlier saves money as well — a lumpectomy is cheaper than a mastectomy, and no chemo is way less expensive than having to undergo months of chemo for a later stage cancer.

I was diagnosed with stage 2B breast cancer at age 47. If I had followed the USPSTF guidelines, I wouldn’t have my first mammo for another year. By that time, the cancer may well have spread to far reaches of my body, and I would be lucky if I survived to see my sixth-grade daughter graduate from high school. If I had had a digital mammogram every year since turning 40, instead of missing one year, my cancer may well have been diagnosed sooner. Losing both breasts and all my hair, vomiting and having bone pain from the chemo was no big deal; telling my daughter (9½ when I was diagnosed) that I had cancer and not being able to be there for her 100 percent because I was too sick, well that was what really hurt.

Thanks to a mammo, a mastectomy and months of chemotherapy, I am able to continue to be a productive member of society as a practicing gynecologist, a wife and a mom for, I hope, a very long time. The 22 other women I mentioned — secretaries, nurses, teachers, businesswomen, clerks, wives, moms, daughters — are all worth saving.

I stand with the American Cancer Society in condemning the USPSTF guidelines.

Dr. Kelly Shanahan owns Emerald Bay Center for Women’s Health, which has offices in South Lake Tahoe and Minden.