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Center studies
breast cancer trend in Latinas
By NATALIA LOPERA, Arizona Daily Star
TUCSON, Dec. 23, 2009 (AP): Josefina Iturralde was told she was
too young to get a mammogram when she was 38, even though she
had pain in her left breast.
For decades up until a few weeks ago, the standard was for women
to get their first mammogram when they turn 40.
But for Iturralde, now 43, it was a huge mistake to follow her
doctor's recommendation.
It turned out to be cancer, but she didn't get diagnosed until
two years later.
Today, Iturralde is worried for other women, because a group of
independent doctors and scientists has recommended that the
majority of women should wait until age 50 to get their first
mammogram.
From then on, the group recommends a mammogram every other year.
It also said the breast self-exam shouldn't be taught because it
doesn't work.
``If my doctor would have listened to me, my prognosis would
have been better,'' Iturralde said as a nurse prepared her for
her weekly chemotherapy at the Arizona Cancer Center.
She ended up losing both breasts, and when it appeared that her
cancer was gone and she was going to get reconstructive surgery,
she was told that it had spread to her liver.
``If I had gotten a mammogram, maybe my cancer would not have
metastasized. Maybe I wouldn't have had to lose my breasts,''
she said.
Latinas in the United States are getting more aggressive forms
of breast cancer, according to a study at the Arizona Cancer
Center.
They also are getting breast cancer at an earlier age. On
average, Latinas are getting it in their late 40s or early 50s,
while non-Latina women get it in their 60s, said Elena Martínez,
principal investigator and co-director of the cancer prevention
and control program at the Arizona Cancer Center.
``The question is: If Hispanic women are getting cancer earlier,
i.e., before their 50s, is this (the recommendations) going to
be worse for them?'' she said. ``We don't have the answer yet.''
The Arizona Cancer Center study found that the majority of women
under scrutiny found their cancers through self-exams, not by
mammograms. And even after finding something abnormal in their
breasts, they still waited before seeking care.
Martínez also said that women who speak only Spanish have lower
rates of seeking mammography. She said she doesn't know if the
new recommendations will discourage Latinas even more.
``(It) may increase awareness and make them question things and
maybe get screened at higher rates,'' she said. ``Or they may
think: 'See? They don't know what they're doing. They can't get
it right.' I don't know which way it's going to go.''
But others—such as Dr. Ana María López, who also is at the
Arizona Cancer Center—say women shouldn't be alarmed because the
recommendations are designed for a specific group of women.
López, who also teaches medicine and pathology at the University
of Arizona and is associate dean at the College of Medicine,
said the recommendations are meant for women who have a normal
risk and have no symptoms.
``If you are not high-risk and you have no symptoms, then this
may apply to you,'' she said. ``But to figure that out, you need
to talk to your doctor.''
She noted that it would not apply to someone like Iturralde who
had pain, because that is a symptom.
Evidence shows it's more common for mammograms done on women who
are 40 to 49 to result in false positives, according to the U.S.
Preventive Services Task Force, the group that made the
recommendations.
The task force said mammograms cause ``psychological harms'' and
that false alarms are followed by unnecessary biopsies. It also
said that mammograms don't really reduce the number of deaths
from breast cancer within this age group.
``We need better tests; the mammogram is the best one we have.
We need something better, especially for younger women,'' Lopez
said.
The task force also said that self-breast exams really do no
good.
``That's not new,'' López said. ``We do not have evidence that
it reduces mortality from breast cancer.''
Martínez explained that by the time a woman feels a lump on her
breast, the cancer is at an advanced stage.
But Martínez and López both agree that it is of value, because a
lump serves as a red flag, and a woman can then go to her doctor
once she finds an abnormality.
It was through a self-breast exam that Iturralde knew she needed
help.
She said her doctor initially thought her pain was due to a
muscle spasm. He later attributed it to her large breast size
and even recommended that she get a breast reduction.
But over time, Iturralde developed a small lump that looked like
a ``mosquito bite,'' and it began to grow. That was when she
decided to switch doctors, and her cancer was diagnosed.
``Listen to your body and your instincts; they tell you the
truth,'' she said. ``If your doctor is not listening to you,
then he is not a good doctor. Find someone else.''
Information from: Arizona Daily Star,
http://www.azstarnet.com
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