American cancer society merchandise

The American Cancer Society is no longer recommending that women do monthly breast self-exams (BSE). Some health-care providers are opposed to this new policy. We asked two experts whether they agree with the revised guidelines.

YES DEBBIE SASLOW, PH.D., DIRECTOR OF BREAST AND GYNECOLOGIC CANCERS, AMERICAN CANCER SOCIETY "Studies have not shown that more lives are saved when women do breast self-exams compared with women who accidentally find a ]ump in their breast. That does not mean BSEs are worthless--many women say they found their own breast lump that way--but their contribution to survival rates is probably small. There's no harm in monthly self-exams, but there's no evidence that once a month is better than every few months."

NO BERT M. PETERSEN, M.D., SURGICAL ONCOLOGIST, BETH ISRAEL HOSPITAL, NEW YORK CITY "We need to be careful about semantics. The studies don't prove breast self-exams don 't save lives. They just show there's not enough information. I still think all women over age 18 should do monthly self-exams--especially as they don't hurt of cost anything, and there are women who first felt their lump themselves. Breast health becomes a top-of-mind issue for those who perform BSE. They're more likely to get annual checkups and, if they find a lump, to know when it first appeared."

New Methods to Detect Breast Cancer

Here's the latest technology for detecting breast cancer and assessing your risk for getting the disease, as well as information to help you decide which technique is right for you.

DIGITAL MAMMOGRAPHY

How it works: Like conventional mammograms, digital mammography uses X-rays to create a picture of the breast. But the images are stored in a computer rather than on film.

Should you ask for it? Yes. Digital mammograms produce sharper images and the results are available faster than traditional mammograms. Not all mammography centers are equipped with digital machines, so ask your radiologist if your center has one.

MAGNETIC RESONANCE IMAGING (MRI)

How it works: MRIs use magnetic fields and radio waves to make detailed images of the body. They're often used to supplement mammograms because they can detect early and small breast cancers that mammograms sometimes miss.

Should you ask for it? MRIs give high numbers of false-positive results, so they're not recommended for most women. But if you're at very high risk for breast cancer (you have a family history of the disease), you may benefit from having an MRI in addition to a mammogram, says Elizabeth Morris, M.D., a radiologist at Memorial Sloan-Kettering Cancer Center in New York City. You might also consider an MRI if your mammogram reveals an abnormality you want checked.

5 WAYS TO JOIN THE FIGHT AGAINST BREAST CANCER

1 CLIP AND MAIL IN THE PINK RIBBON ON CARTONS OF EDY'S OR DREYER'S FROZEN YOGURI FOR EACH RIBBON RECEIVED, THE COMPANY WILL DONATE $1 TO CANCER RESEARCH. FOR MORE INFORMATION, GO TO EDYS.COM.

2 VISIT THEBREASTCANCERSITE.COM. WITH EACH CLICK ON THE SITE'S "FUND FREE MAMMOGRAMS" BUTTON, THEIR SPONSORS WILL DO JUST THAT.

3 ORDER PINK-RIBBON MERCHANDISE AT KOMEN.ORG THE WEB SITE FOR THE SUSAN G. KOMEN BREAST CANCER FOUNDATION. UP TO 80 PERCENT OF THE PROCEED WILL GO TOWARD FUNDING BREAST-CANCER RESEARCH, EDUCATION AND SCREENING.

4 GET A FREE OR DISCOUNTED MAMMOGRAM ON OCTOBER 17, WHEN THEY WILL BE PROVIDED BY RADIOLOGISTS NATIONWIDE. GRAB A GIRLFRIEND TO GO WITH YOU. TO LEARN MORE, CALL THE AMERICAN CANCER SOCIETY, (800) 227-2345.

5 HELP RAISE MONEY FOR CANCER RESEARCH BY PARTICIPATING IN THE KOMEN FOUNDATION'S RACE FOR THE CURE, THE LARGEST SERLES OF 5K RUNS/WALKS IN THE WORLD. GO TO KOMEN.ORG, TO FIND THE RACE NEAREST YOU.

DUCTAL LAVAGE

How it works: A catheter inserted into the nipple flushes out a sampling of cells from the milk ducts, where 95 percent of breast cancers originate. The cells are examined for early abnormalities that may be a precursor of breast cancer.

Should you ask for it? The procedure is recommended only for those women with a high risk of breast cancer who want a more precise calculation of their odds of getting the disease, says Lawrence Wickerham, M.D., associate chairman of the National Cancer Institute's National Surgical Adjuvant Breast and Bowel Project.

GENE TESTING

How it works: DNA is taken from a biological sample, usually blood, and examined for mutations in two genes, BRCA 1 and BRCA 2. An abnormality signals an increased risk of developing breast cancer.

Should you ask for it? The likelihood of cancer being associated with BRCA 1 or 2 is highest in families with a history of the disease. So if you have two or more family members who have had breast or ovarian cancer, talk to your doctor about being tested. But keep in mind that a negative test result doesn't guarantee that you won't develop cancer.

ULTRASOUND

How it works: High-frequency sound waves create a detailed image of the breast. Ultrasound is sometimes used to supplement mammograms.

Should you ask for it? The American Cancer Society says ultrasound can miss small calcium deposits, one of the earliest signs of cancer. It's only recommended for investigating a lump that doesn't show up on a mammogram, or as a follow-up when a mammogram has found something suspicious, or if you're at very high risk for breast cancer.