If you’re feeling confused about when and how often you should have a mammogram, you’re not alone. Since new mammogram guidelines were released this fall by the U.S. Preventative Services Task Force, many patients and personal acquaintances have asked my advice because they’re confused about whether to change their current routine—or when to begin a new one.

The new U.S. Preventative Services Task Force guidelines recommend that women of average risk for breast cancer wait until age 50 to begin getting regular mammograms, and that they do so biannually instead of annually. Their research concludes that there isn’t a clear benefit to earlier or more regular screening for women in their 40s. They also recommend that screening stop after age 74.

However, in response to these guidelines, the American Cancer Society, the American College of Radiology, and the Society of Breast Imaging have announced that they will continue to advise women to begin screening at age 40 and to have annual mammograms after that. They believe that early screening saves lives because the earlier the disease is diagnosed, the more effectively it can be treated.

If you are at high risk for breast cancer or have a history of the disease in your family, screening should begin much earlier, and it might also involve other imaging or diagnostic procedures. Your best course of action would be to begin discussing breast health with your doctor when you are in your 20s.

Here’s the bottom line: if you’re concerned about breast cancer, you should discuss your situation with your doctor or other health care provider, who can help you determine your risk factors and customize a personal plan for you.

This post addresses three common questions my patients have following breast cancer reconstruction:

1. Will breast reconstruction hide other tumors that may later appear in the breast tissue?
2. Will breast reconstruction encourage the growth of new cancerous cells?
3. Should I continue with regular mammograms and breast self-exams?

Does breast reconstruction hide subsequent tumors?

During a mammogram, implants can occasionally interfere with obtaining a good picture, so your technologist must be trained at positioning the implant to enable the best possible image. In a flap reconstruction, the mammogram image may reveal surgical clips or scars, or the breasts might appear fatty, but an experienced technologist will be able to detect any abnormality. Breast reconstruction rarely, if ever, hides a return of breast cancer, so you shouldn’t consider this a significant risk when deciding to have breast reconstruction after mastectomy.

Will breast reconstruction encourage the growth of new cancerous cells?

No research has shown that reconstruction, either with implants or tissue flaps, increases the risk of the breast cancer returning or of a new cancer forming.

What about mammograms and breast self-exams?

After your reconstruction, whether it involves implants or tissue flap reconstructions, it is important to have regular mammograms at an experienced facility. I also encourage you to keep performing breast self-examination on both breasts as soon as you are fully healed from your surgery. This will enable you to notice and report any changes you feel. You should expect your reconstructed breast to feel different, and your doctor or nurse can help you understand the changes.

Every breast cancer patient I have met remembers the exact moment she learned of her positive diagnosis, the moment her life changed. Following diagnosis, it’s difficult to think of anything else, and it’s common to feel angry, resentful, confused, depressed, or extremely emotional.

If you or a loved one has been diagnosed with breast cancer, I encourage you to participate in a support group because doing so can benefit your mind, body, and spirit. Research has shown that those who actively pursue the companionship of others with breast cancer can decrease stress levels and boost their immune system.

In a support group, you will learn about and from others’ experiences, discussing everything from mood swings to side effects, sleep disturbances to alternative and advanced therapies. Most importantly, you will discover that you’re not alone.

Support groups can meet in person or online. To locate a group in your area, contact local hospitals or breast cancer clinics, or one of the following organizations:

• The National Cancer Institute’s Cancer Information Service, 1-800-4-CANCER (1-800-422-6237)
• Local chapters of the American Cancer Society and Susan G. Komen for the Cure

For those who live in remote locations or prefer an online support group, many resources are available, including the Breast Cancer.org discussion forums. If you are considering mastectomy, the DIEP Sisters Web site provides an excellent resource for support. It also discusses alternative methods of breast reconstruction after mastectomy, focusing on the DIEP flap.

In my own office, the DIEP Flap Support Group was formed over 13 years ago because many patients had a difficult time finding other people to talk to who had undergone the same surgery. Meetings are held once a month, in a very positive mood and setting. Most members are willing to speak to patients considering the DIEP flap for breast reconstruction, so if you’re interested, phone my office at (516) 482- 1100.

One year ago DIEP flap breast reconstruction became available at Huntington Hospital when Drs. Keller and Yoon-Schwartz joined the staff. DIEP flap breast reconstruction utilizes sophisticated microsurgery to reconstruct the breast after a mastectomy from excess abdominal fat. As a side benefit, the patient also ends up with a tummy tuck. The result is the most natural and soft breast reconstruction available. Unlike other techniques, the abdominal muscles are not sacrificed. Dr. Keller has been a pioneer in this type of reconstruction and has been performing DIEP flap breast reconstruction for over 15 years.

There are very few places in the country where this type of reconstruction is available. Huntington Hospital is now on that list and is the only hospital in Suffolk County where this procedure is available. Huntington Hospital has made the commitment to support this service by purchasing a new operating microscope that is ideal for successfully performing this procedure.