Dianne Feinstein is memorialized in the US Congressional Record recognizing that the hands of women and clinicians are the first, effective and affordable method to find and treat the earliest sign of breast cancers.
She insisted therefore that women receive clinical (physical) breast exams within the breast and cervical early detection programs that receive federal funds. It is observed however, that the Congressionally mandated support for early detection often goes directly and exclusively to the imaging industry whose businesses and practitioners do not provide clinical breast exams and essential staff training.
Some intrepid state health departments, recognizing Feinstein’s assessment and the clear requirements of the law, have recently begun to train and verify the hands of all their providers, giving them the skills to perform competent breast exams. Unfortunately for women however, most states including Florida, continue to direct women to private mammography businesses who do not train their providers to perform clinical breast exams and do not perform them.
When a patient finds (palpates) a small early cancer, the tumor may not be visible in an image so the patient is often sent home to wait until it is unavoidably obvious. An image may finally confirm months later what was felt earlier. This is referred to as an "interval" cancer, meaning we missed it because we did not possess the skills required to confirm physically what the patient could. This common but avoidable error results in later stage more invasive, debilitating and costly cancer.
Breast cancer is now the most common cancer with nearly 300,000 new cases each year. Treatment can extend life even at later stages due to a gap in detection, but trained clinical hands can close that gap for millions of women. To her eternal credit, Dianne Feinstein got it right for all women, with sincere personal appreciation from my three wonderful daughters.
Mark Kane Goldstein, Ph.D.
Senior Scientist and Director
The MammaCare Foundation