Sarah McLean was just 26 years old when a self-exam revealed a lump that later was diagnosed as breast cancer.
McLean was 19 years younger than the age the American Cancer Society (ACS) recommends women begin having mammograms, and the self-exam she credits with saving her life is no longer recommended by the ACS.
The two-time breast cancer survivor was at St. Mary’s Women’s Imaging Center, in Enid, Okla., Friday, for the “Think Pink” luncheon, to raise awareness of breast cancer and to encourage women to be proactive in their health.
McLean said she and her husband had only been married about a year when she found that first lump in 2003. What followed, after her diagnosis, was a long course of radiation, hormone therapy, a double mastectomy and multiple reconstructive surgeries.
Despite undergoing a double mastectomy, McLean suffered a recurrence of breast cancer in 2011. More treatments followed, and more surgeries — she’s now had a total of 13 surgeries to remove cancerous tissue and reconstruct the affected areas.
Looking back on her experience, McLean credits one piece of medical advice with saving her life.
When she was 18 years old, McLean’s doctor recommended she begin regular breast self-exams. She followed that advice, and said it was the self-exams that led to the discovery and treatment of her breast cancer.
Dr. Emily Cooper, M.D., a family medicine physician at St. Mary’s Physician Associates and emcee of the “Think Pink” luncheon, said McLean’s story underscores the importance of following breast cancer screening guidelines, and for women to know their family history, be proactive about their health care and have an annual exam with their doctor.
Breast cancer exam guidelines have changed in recent years, pushing recommendations for mammograms into later years, further from when McLean was diagnosed.
According to ACS guidelines, all women should begin having yearly mammograms at age 45, should have them available at age 40 if desired, and can change to having mammograms every other year beginning at age 55. According to ACS figures, less than five percent of women diagnosed with breast cancer are younger than 40.
While McLean credits her breast self-exam with leading her to detect and successfully treat her cancer, new medical guidelines also are leading women away from self-examination.
Breast self-exams, long a mainstay of early detection recommendations for women, now are not recommended by the American College of Obstetricians and Gynecologists and the ACS.
ACOG changed the guidelines last summer, citing stress placed on women by false-positive breast exams.
“Breast self-examination is not recommended in average-risk women,” ACOG stated in a July 2017 bulletin, “because there is a risk of harm from false-positive test results and a lack of evidence of benefit.”
ACS also changed its recommendations to not recommend self-exams, effectively reversing course on years of marketing campaigns urging women to conduct breast self-exams.
Recommendations also became less clear for physical breast exams conducted by a physician.
The July 2017 ACOG bulletin states there are conflicting guidelines from ACOG, the National Comprehensive Cancer Network, ACS and the U.S. Preventive Services Task Force on whether or not to perform clinical breast exams in women at average risk of breast cancer.
Be your own advocate
In the face of changing, and even contradictory, recommendations on breast examinations, Cooper said it’s increasingly important for women to take ownership of their health and be engaged with their doctor.
“Know your history, know your body, have an open dialogue with your doctor and be proactive about your health,” Cooper said.
While ACS and ACOG may have changed their guidelines on breast self-exams, McLean remains adamant in recommending women “know their bodies.”
“It’s really important for you to know your own tissue,” McLean said, “and to be your own advocate.”
Based on her experience with breast cancer, McLean founded in 2007 — in between her two cases of breast cancer — Project 31, a nonprofit faith-based support group for breast cancer patients and survivors.
“Through the emotional ups and downs of the treatment process, we just found there weren’t that many resources available,” McLean said.
She said support is needed not just for breast cancer patients, but for all the people in their lives.
“Cancer doesn’t just affect the survivor,” McLean said. “It affects their partner, and the whole family. It is a ripple effect.”
McLean said her faith helped get her through cancer treatments, and led her to start Project 31 to help others.
She said she avoided support groups initially because “I had stereotyped support groups as a toxic environment of gloom and despair,” and she’s worked to create an environment to “educate, equip and empower women.”
Since 2007 Project 31 has grown to a presence in 10 hospitals in Oklahoma City, Stillwater and Tulsa, with more than 800 women in support groups this year.
McLean said all those women share an undesired, but undeniable, bond.
“It’s an unlikely sisterhood you wouldn’t sign up for,” she said, “but there’s definitely a common bond once you’ve been there.”
For more information on Project 31 visit project31.com.