DATE: Monday, March 10, 1997                TAG: 9703080017

SECTION: LOCAL                   PAGE: B9   EDITION: FINAL 

TYPE: Opinion 

SOURCE: Ann Sjoerdsma 

                                            LENGTH:   89 lines

HARMFUL MIND-SET ABOUT BREASTS ALSO A CNACER FOR WOMEN

When I turned 35, my gynecologist told me ``it was time'' that I get a ``base-line'' mammogram.

``Gee, doctor,'' I replied, ``can't I wait until I'm 36?''

One day, I'm 34 and cancer-free, the next I'm middle-aged, my breasts conceal malignant tumors and I'm gonna die. But not before I'm surgically disfigured and de-womanized. For my 35th birthday, I got a death sentence.

Sound crazy? Maybe. But such a reaction aptly captures a damaging mind-set in this country, one that teaches women to pay far too much attention to our breasts; to dislike them, because they're imperfect, and eventually to fear them.

This mind-set underlies the angst caused by the hardly surprising news that mammograms are not especially effective cancer-screening devices for women in their 40s. And, in fact, may do more harm, especially psychological, than good.

Lately, to help ``confused'' women, the media have seized upon the monthly breast self-exam, what Christiane Northrup, a ``mind-body'' obstetrician-gynecologist and author of Women's Bodies, Women's Wisdom, calls the ``search and destroy mission.''

This is when ``you make your hands into two mine sweepers . . . and try to find something that you don't want to find that may kill you,'' says Northrup, co-founder of Women to Women, an innovative health-care center in Yarmouth, Maine.

And God bless her for saying so.

Monthly self-exams are important, Northrup notes, but they should be of the whole body, not just the breasts, which ``aren't anything special.'' And the exams should be relaxing, pleasurable.

Unfortunately, we're breast-obsessed, and the obsession has little to do with women's comfort or pleasure, much less our health.

Medicine, by emphasizing disease rather than health, helps to perpetuate this mind-set. So do feminists who talk up scary and misleading breast-cancer statistics. But the media, which exploit women's breasts and misinform about breast disease, are the worst offenders.

Check out the nice set of implants on the cover of this year's Sports Illustrated swimsuit issue. This is ``beauty''?

I welcomed the January decision by the National Institutes of Health panel not to recommend routine mammograms for women in their 40s. Scientists not only yielded to the weight of the evidence, rather than to political pressure, but they gave the individual woman more control over her own well-being.

After all, M.D. does not stand for medical deity.

But the old mind-set quickly intruded - in the furor expressed by opposing scientists and consumer advocates, who have their own agendas, and in oversimplification by the media.

Peter Jennings actually apologized to women for not being able to provide clear guidelines on mammograms. ABC's ``experts'' then rebuked the NIH panel. Balance? Objectivity? Forget it.

I wonder: Did ABC apologize when the National Cancer Advisory Board confirmed the NIH's assessment in late February? Or did it ignore the report? NCI director Richard Klausner, who loudly disagreed with the NIH and sought the advisory board's ``second'' opinion, quietly ate some humble pie.

``People abhor a vacuum of knowledge. That gives them anxiety,'' a subdued Klausner explained to The Washington Post.

Not me. I can accept a lack of proof. I abhor anxiety, which I've felt with both of the mammograms that I've had. Unnecessarily so.

After my base-liner (at 36), the ``lab'' called: ``The doctor found something on your mammogram. We'll have to schedule another.''

``Something?'' I asked. ``And just what exactly is a `something'?''

Don't get me wrong. Breast cancer is a deadly disease. But that does not negate the fact that women have learned to overestimate its probability. (As well as the benefit of mammography.)

``One in eight'' women does not develop breast cancer.

According to the National Cancer Institute, only women age 90 and older have a one-in-eight breast-cancer risk. At age 20, says the NCI, the risk is one in 2,500; at 40, one in 63; at 60, one in 28, etc.

The incidence of breast cancer in women my age, between 40 and 44, is 128.3 per 100,000.

Of course, none of these projections begins to account for individual risk factors.

According to the Centers for Disease Control and Prevention, breast cancer causes 4 percent of all deaths in women. Heart disease claims many more lives. So why do we always hear about the number of women who die each year from breast cancer but not the number of others who died and from what?

Statistics can and do manipulate the truth and raise fears.

Says Northrup: ``We're teaching an entire generation that the breasts are two premalignant lesions sitting on your chest.''

I couldn't agree more. We need to look more at the sum of our parts. We need to get whole. MEMO: Ann Sjoerdsma, an attorney, is an editorial columnist and book

editor for The Virginian-Pilot.

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