Let me start by saying that I was 44 years old when I was diagnosed with breast cancer by a mammogram. My tumor was not palpable (you couldn't feel it) and it was aggressive. I was lucky. The cancer was caught very early and had not spread to the lymph nodes. I was stage 1.
Mammograms are painful, no doubt about it. I certainly wouldn't have had a mammogram if it was up to me. I wasn't on anyone's breast cancer radar even though my grandmother passed away from breast cancer in 1978. My mother was diagnosed at 65 years of age. I always thought of breast cancer as an "old woman's disease." At 44, I didn't consider myself "old."
Given my history, I am ambivalent about the US Preventative Services Task Force's new guidelines. I completely understand the "science" and "evidence" behind their decision, but, to me, even 1 death out of 1,900 women between the ages of 40 and 49, is too many. That death could have been me.
The task force doesn't recommend the breast self exam (BSE). Ok. Again, I get the evidence. But in the same vein, what's wrong with promoting each woman examining their breasts on a monthly basis? They certainly don't have to do the "formal" BSE, but whatever works for each woman is what counts. If a woman feels comfortable following the instructions on the shower card, what's wrong with that? The point is to know which lumps feel normal in your body and which lumps are new.
I think the bottom line is to know your body. Start a conversation with your gynecologist, internist, or the doctor that watches your health on a yearly basis. Tell them your cancer history, even if they don't ask. (And, by the way, if they don't ask, maybe look for a new doctor). Don't be afraid to call or email them (yes, you should have their email address) if you feel that something has changed in your breasts. Becoming familiar with your body is the first step in taking charge of your health. Remember, you are your own best advocate. Keep it that way.