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Lehigh Valley oncologist differs on new breast cancer screening guidelines

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SALISBURY TOWNSHIP, Pa. - Breast cancer screening guidelines recently changed, but a local oncologist disagrees with some of the new conditions.

"If we have a screening test that is good at finding things before they find us, then why not utilize it when it's most appropriate, when the risk becomes significant, which is women 40 and above,” said Dr. Lori Alfonse, the deputy physician in chief of the Lehigh Valley Topper Cancer Institute.

The new recommendation from the U.S. Preventive Services Task Forcesuggests women get mammograms every other year starting at age 40, and continuing through age 74. The old recommendation from the task force was that women begin screening at age 50.

The breast surgical oncologist said the new recommendations are based on numbers and trends, not firsthand experience.

“This task force is not comprised of anybody that's actually involved with direct breast care,” she said.

The team at Lehigh Valley Topper Cancer Institute recommends women 40 years and older at average risk get checked every year.

"The yearly mammograms allow continuity, allow our fellowship trained imagers to take a look at your picture and compare it kind of in an apples to apples fashion from last year to this year, and assess subtle changes when something could be small,” said Alfonse.

She added that breast cancer is most curable and most treatable when found early. She also recommends people with a family history of breast cancer, or who are at higher risk, be screened more often and may need more thorough screenings.

“The two biggest risks any woman has are having breasts and living long enough to get it."
Dr. Lori ALfonse, Deputy Physician in Chief, Lehigh Valley topper Cancer Institute

“The two biggest risks any woman has are having breasts and living long enough to get it,” she said. “So, the greater we age, the higher our risk and that's just because genetic changes happen as a result of damage from the environment in general, air we breathe, water we drink, food we eat, stress we were under.”

Alfonse says she is seeing more instances of cancer in people younger than 40.

"I saw five women under the age of 40 in a four-week time period that had palpable breast masses that turned out to be malignant that had no family history and no genetic component,” she said. “So the environment continues to play a huge role in the formation of breast cancer and in fact — 85% of all breast cancers, and that's probably a low number — are environmentally caused.”

She went on to say self screening is also just as important as getting a yearly exam.

She says women know their own bodies and need to stay vigilant in looking for any changes.

“Covering all areas of your breast tissue all the way up to your clavicle, all the way down to where your bra hits, all the way over to your chest bone, and all the way over kind of to your armpit area,” she said.

Alfonse said if anyone finds something on their body out of the ordinary, they should get it checked by a primary care doctor — even if it seems like a minor change.