PALM SPRINGS, Calif--Women often develop idiosyncratic ideas about their risk for breast cancer, Mary Jane Massie, MD, said at the Academy of Psychosomatic Medicine in a session on counseling high-risk women. And the higher the perceived risk, the less likely these women may be to confront their fears and comply with preventive regimens such as breast self-exam (BSE).
"Breast cancer gets more play in the media than any other disease right now, so it is important for us to be able to teach patients the real risk factors," said Dr. Massie, attending psychiatrist and director, Barbara White Fishman Center for Psychological Counseling, Evelyn Lauder Breast Cancer Center, Memorial Sloan-Kettering Cancer Center.
This type of education for high-risk women is available at high-risk surveillance clinics such as the one at Memorial Sloan-Kettering, which is staffed by surgeons, plastic surgeons, nurses, psychiatrists, psychologists, genetics counselors, and nutritionists.
Women are referred to the clinic because they have a family history of breast cancer or have atypical breast changes. Frequently, these women are young, often the daughters or sisters of women who have had breast cancer.
At the Memorial surveillance clinic, regular monitoring of women at high risk includes clinical breast examinations every 6 months. Mammography schedules are determined by a surgeon, based on the woman's age and evidence of atypical changes in the breasts, Dr. Massie said.
Those women who are too anxious to perform BSE on a regular schedule should be told that their physician will perform the examination, but they may need to be seen more frequently.
Study Shows Low BSE Performance
Pierre Gagnon, MD, a psychiatrist at the Hotel Dieu Hospital, Quebec City, reported on his research of women who presented at Memorial's high-risk surveillance clinic. He discovered that 61% of these women performed BSE less than once a month, and 59% of them expressed a lack of confidence in their ability to perform BSE adequately.