Doctors' NotesLifestyle

Doctors’ Notes: Breast Cancer Screening

Credit: Thinkstock

Welcome to Doctors’ Notes, our newest contribution from Urban Health correspondents and husband and wife physicians Dr. Rob and Dr. Karla Robinson.  The dynamic duo will be fielding questions about health, as it relates to African Americans.  Please feel free to send them questions via our contact us form.  We promise to keep it anonymous. 


Question:  I am a 40-year-old married mom of two.  I have no family history of breast cancer, but I helped my mother-in-law as she battled breast cancer many years ago, and we are currently dealing with the breast cancer diagnosis of her two daughters–both under the age of 40!

I want to make sure that I do everything I can to get my mammogram screening on time, but I am not sure when I should start.  Do I start now or wait until I’m 50? Help?!

Dr. Karla says:

With all of the conflicting information out there regarding who should get a breast cancer screening, when to get screened and how often, it is no wonder that you are confused.  The U.S. Preventive Services Task Force recommends yearly mammogram screening in women beginning at age 50, and every two years thereafter.  Most clinicians agree that this delayed recommendation for screening could be missing a vast number of women who could be diagnosed with breast cancer at an early stage.  This is particularly true for African American women.

Research shows that an estimated 1 out of 3 African American women with breast cancer were diagnosed before the age of 50, and 1 out of 10 were diagnosed by the age of 40.  This is why I recommend that my patients follow the American Cancer Society guidelines, which state that mammography screening should begin for each woman of average risk (no family history) at age 40 and yearly thereafter.

You should certainly talk to your doctor now about your specific medical history and screening indications.  Although you mentioned that you don’t have a family history of breast cancer, you are definitely still at risk.  In fact, more than 85 percent of women diagnosed with breast cancer have no family history of the disease.

While statistically African American women are less likely to be diagnosed with breast cancer, we are more likely to die from it.  This is perhaps because we have more advanced stages of the disease at the time of diagnosis, which is why screening is so important.

Dr. Rob says: 

Now while making sure you get screened on time, let’s also not forget your husband may need screening as well.  Yes, men CAN and DO get breast cancer.  It is estimated that this year alone, there will be more than 2,200 new cases of invasive breast cancer in men.

Given the fact that your husband has had multiple immediate family members with breast cancer, there is a chance that the family may have the genetic BRCA1 and BRA2 mutation, which puts him at an even increased risk.  While there are no definitive mammography screening guidelines for men, it might be worthwhile for your husband to discuss the need for genetic testing with his doctor.

Signs of breast cancer to look for are really no different in men than in women.  In fact, because there is significantly less breast tissue in men, those subtle skin changes just may be a little easier to detect.

If you notice any of the changes below in the breast tissue, male or female, be sure to see your doctor immediately:

*Lump, hard knot or thickening in the breast, chest or underarm area (usually painless, but may be tender)

*Change in the size or shape of the breast

*Dimpling, puckering or redness of the skin of the breast

*Itchy, scaly sore or rash on the nipple

*Pulling in of the nipple (inverted nipple) or other parts of the breast

*Nipple discharge

Early diagnosis saves lives.  Let’s make sure we encourage one another to get screened.

It’s a health thing…we’ve got to understand!

About the Doctors:

Dr. Karla and Dr. Rob are the founders of Urban Housecall Magazine and host the Urban Housecall Radio Show.  For more from the doctors, visit their website at, like them on Facebook UrbanHousecallMagazine, and follow them on twitter @urbanhousecall!