CHECK OUT THOSE BREASTS

Forty percent of American women skip their annual breast exam. Why? Well, whether you're in for a mammogram or a manual checkup by your gynecologist, having your breasts palpated, squashed and smashed in the name of health-consciousness is not exactly a day at the beach. Couple that with the scant possibility that all this unpleasantness could result in a cancer diagnosis and most of us would rather spend our time voluntarily undergoing a root canal.

But there are a lot of good reasons to join the 60% of women who do get their breasts checked every year. For one thing, participating in screening is, hands-down, the best thing you can do to decrease your risk of dying from breast cancer. And the dread we feel when facing down the morbid proposition of an annual cancer screening isn't as founded in reality as you think. Twenty years ago, a breast cancer diagnosis was tantamount to a death sentence. But mortality rates have steadily declined since 1990, according to the National Cancer Institute (NCI), and today there are around 2.5 million breast cancer survivors in the United States.

Furthermore, the medical community is well aware that a lot of us aren't getting our yearly mammogram because of the comfort factor, and is hard at work developing new technology to make breast exams shorter and easier. Digital mammography means you spend less time with your breasts squashed against a plate of glass and more time going about your day. To find out if your imaging center offers it, just call ahead and ask. There have been other, less tangible advances as well: dedicated "women's imaging centers," staffed with specialists in breast cancer detection and treatment and designed to feel like swanky day spas, are popping up all over the country.

We're gaining ground against breast cancer in this country in large part because of two little words: early detection. The technology used to find and treat breast cancer has improved by leaps and bounds over the past few years, and new ways to enhance traditional screening are constantly emerging. On average, mammography detects 80 to 90% of cancers in symptom-free women; similarly, the Agency for Healthcare Research and Quality estimates that 80 to 90% of abnormal mammograms are false positives. But it's better to have a false positive than an undetected negative, and even worse not to check at all. Just last year, the American Cancer Society revised its guidelines to include an annual MRI for high-risk women, in response to a mounting pile of evidence that MRI and mammography together are more sensitive than mammography alone.

But all the innovations of the past two decades are useless if you don't take advantage of them. The NCI estimates that one in eight women will be diagnosed at some point during their lives; around 40,000 women will die of breast cancer this year. How many of those lives could've been saved by early detection? For a hint, we can look to the ACS' 2007-2008 Breast Cancer Facts and Figures report, which states that the annual mortality rate for breast cancer decreased 2.2% every year between 1990 and 2004. "The decline in breast cancer mortality since 1990 has been attributed to both improvements in breast cancer treatment and to early detection," notes the report.

The ACS' new recommendations for breast screening break down as follows:

• If you're in your 20s, a clinical breast exam (CBE) every three years
• If you're in your 30s and at low/normal risk, a CBE every three years
• If you're in your 30s and at medium risk (15%), a mammogram every year
• If you're in your 30s and at high risk (20%), a mammogram and an MRI every year
• If you're in your 40s and at low/normal risk, a mammogram every year
• If you're in your 40s and at medium or high risk, a mammogram and an MRI every year

To access a free, online risk assessment tool, visit http://www.cancer.gov/bcrisktool. And for information on low-cost breast cancer screening, check out www.cdc.gov/cancer/nbccedp. That miserable few minutes could add years to your life.

For one woman's account of a particularly hilarious - and harrowing - mammogram, check out Cindy Chupack's "Happy Mammogram!"

******

Cat Vasko is the associate editor of SU2C's web magazine. She is a freelance writer with years of experience living and breathing oncology and radiology.