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WE HAVE DECLARED ALL OUT WAR
on Prescription Drug Prices::
Say-On Drugs Warren Prescriptions
Say-On Drugs
Orchard Lk Rd at Maple
Telegraph Rd. & Maple
248.626.3400
248.626.2525
Middlebelt Rd. & 14 Mile
248.855.1177
(Next to Hiller's Market)
SAVS10Ik
DRUG STORES
(Next to Johnny Pomodoro's
Fresh Market)
1440950
ORTHODONTICS
Steven M. Lash, DDS, MS
Rebecca L. Rubin, DMD, MS
248-851-7272
6177 Orchard Lake Road, West Bloomfield, Michigan
www.lashorthodontics.com
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)11 tit
(...)r thOdoIlliStS
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1430850
B4
October 30 • 2008
Ai
I
'm a healthy survivor
of three breast cancers.
My internist husband
felt my first tiny cancer when
I was 38.1 saw my second
serious lump when I was
44. The third was found on
MRI when I was 49. All were
found before they spread to
my lymph nodes.
Two of my three cancers
were found outside of a
doctor's office. Most women
should not rely on their
doctor's physical exam.
Dr. William Goodson reported, at
the 2007 San Antonio Breast Cancer
Symposium, that 79 percent of women
receive inadequate breast exams from
their physicians. His survey of 320
women found that only 70 received the
minimal two-minute exam, while the
others received less or none at all.
While mammograms save lives,
they can't be counted on to find all
breast cancers. In fact, mammograms
miss between 30-34 percent of breast
cancers. Non-digital mammograms
miss half of breast cancers in women
younger than 50. (New England
Journal of Medicine Oct. 27, 2005). The
exact percentage of mammographic
misses may vary due to different study
methodologies. Still, it's clear that this
common screening test misses signifi-
cant numbers of breast cancers.
Currently, routine MRIs are not a
viable alternative to screening mam-
mography: Cost and high benign biop-
sy rates limit their widespread use.
So, how can a woman protect her-
self? Dr. Goodson suggests that women
ask their doctors to take a full two
minutes to examine their breasts. His
Web site, 2minutebreastexam.com,
explains his approach and includes a
video of a doctor doing the examina-
tion. I say, "More power to Dr. G and
the women who have the chutzpah
to follow his advice." Still, I see a few
problems with this.
Two minutes is an absolute mini-
mum and it doesn't ensure that the
doctor's technique is effective. An
article in the Journal of the American
Medical Association (Oct. 6, 1999)
states, "The preferred technique for
clinical breast exam (CBE) includes
proper positioning ... thoroughness
... use of a vertical-strip search pat-
tern ... and a CBE dura-
tion of at least 3 minutes
per breast!'
I created, teach and
practice the BrA (Breast
Awareness) approach to
examination to give other
women the same advan-
tages I've had in surviving
breast cancer. BrA incor-
porates teaching, practice
and insight. A shower card
or a newspaper article
can't convey it. It is taught
in two-hour seminars
open to all women at Karma Yoga,
in the Silver Linings Breast Cancer
Survivor's Workshop and by special
arrangement.
Of course, prevention of breast can-
cer trumps efforts at early detection.
Regular exercise (at least 30 minutes
of moderate to vigorous physical activ-
ity, above usual activities, on 5 or more
days per week), maintenance of normal
body weight, limitation of alcohol intake
(not more than one drink per day) and
avoidance of estrogen and progesterone
supplementation are consistently shown
to decrease the likelihood of developing
breast cancer. Using preventive medi-
cations or surgeries are challenging
choices, though they may be lifesaving
for women at very high risk.
For the health of my patients,
friends and family, I recommend an
individualized combination of self-
awareness and empowerment practic-
es, good clinical breast exams, regular
medical follow-up, mammograms,
genetic counseling/testing, MRI, medi-
cations and surgery. 1:1
Ruth Lerman, M.D., sees high-risk individu-
als, breast cancer survivors and patients
with other breast concerns. She works
from the Beaumont Breast Care Center,
Royal Oak, (248) 551-3300. She emphasiz-
es CBE, prevention and early diagnosis of
breast cancer as well as mind-body medi-
cine to the medical students, physicians
and nurses whom she teaches.
Information on BrA workshops
at www.karma-yoga.net or (248)
723-9168.
Information on BrA workshops
at Silver Linings Breast Cancer
Survivor's Workshops, (248) 551-
4645.