JACKSONVILLE, Fla. -- Dr. Suprith Badarinath, a physician with North Florida Hematology and Oncology Associates, was at Channel 4's studios answering questions about a recommendation to change the long-standing recommendations for women to begin getting annual mammograms at age 40 and perform regular breast self-exams.

Here is the entire archived 5 p.m. to 6:30 p.m. chat session:

news4jax(P) Welcome to our chat on the changes in suggested policy on mammograms.

suprith_badarinath_md Now is the time for all good men to come to the aid of the country.

greybeard If the research shows mammograms aren't needed for everyone until age 50, that makes sense to me, but why discourage women from self-exams?

Daniel Im not understanding what this is exactly about?

suprith_badarinath_md The question of screening for breast cancer is very difficult, and the answers are rarely straightforward.

alymae I cant believe what i heard on the news, if it wasnt for self exams my mother , aunt and sister would be dead by now

alymae my sister was diagnosed at age 18

suprith_badarinath_md The latest guidelines have been an attempt to systematically and dispassionately address the question of what works and what doesn't work for breast cancer screening.

Daniel My, mothers friend died last week from Breast Cancer. We were all so sad.

suprith_badarinath_md We know that there are many many cases that we have seen where patients have found their own breast cancers, and even more commonly it is found on mammography.

alymae i had an aunt die a cpl mths ago due to complications of breast cancer

mmcdonaldhlatky i would like to see a machine that dons't pinch my breast

suprith_badarinath_md Breast self exam is cheap, and involved no radiation. The problem with breast self exam, as with any other screening is the risk of false positives.

Daniel Im sorry alymae.

alymae I am 39yrs old I do a monthly exam and a yrly mamo & sonogram

Daniel I dont understand how you do a self exam?

alymae my moms sister was diagnosed on march with stage 1 and in april my mother stage 2

suprith_badarinath_md The biggest reason that the task force was unenthusiastic about breast self exam and mammography for younger women was the number of false positives - meaning findings that led to a negative, noncancerous biopsy.

alymae my mom is done with chemo and having her surgery in 2 wks

alymae she tested positive on the breast cancer gene

suprith_badarinath_md A breast self exam is a particular, systematic way that a woman can examine her own breast. It is essentially what the doctor does during a physical.

alymae but what about the ones who have the genes and cancer that runs in their families?

Daniel What if its too deep to see or feel?

suprith_badarinath_md For people with Brca positivity, screening is much more important, because we will have more cancers found, and fewer benign biopsies.

alymae a doctor refused to give my sister a mamo at 18 , she went about a yr with a lump and ended up going to another doctor, she ended up having a double myst at age of 20

Daniel You can never be sure. Because im worried every day about it. My breasts are not that big but i dont know what to look for.

mmcdonaldhlatky what about men who find lumps, I hane never guidlines for men

suprith_badarinath_md Breast screening is still important, but the problem is finding out the best schedule, what tests to use, and when to start.

alymae i saw on a talk show about a new test for younger ppl with small breasts, have you heard or seen it, it kinda looks like a breast pup?

suprith_badarinath_md Breast screening includes mammograms and ultrasoung

suprith_badarinath_md ultrasoud

suprith_badarinath_md Newer imaging techniques may improve screening in the future, but more research is needed.

alymae i end up having both because i have cystic breast disease, so im always lumpy

Daniel On my right breast i have recently got a discolored patch. Its not a lump or anything, Also its not a bruise. What could this be?

suprith_badarinath_md Alymae's situation is one that may be helped more by screening that other people. In the future we may develop personalized recommendations.

suprith_badarinath_md Daniel. The most important thing we look for on exam or on the mammograms and other tests is change. The longer something remains unchanged, the less risky the finding is.

Daniel Where is the best place to go and get tested?

greybeard There's been questions about the timing of this government panel recommending reducing cancer screenings at the time they are debating the health bill in congress and ways to control costs. Could there be any connection?

alymae look my mother never did a breast exam in her life, she is not a peron who goes to a doctor, im always harping on her to do an exam, more so because of my sister, her age and past menopause, well one day in shower,my words came to her and she did an exam, and needless to say she found 3 lumps 2 cancer & 3rd not, both lumps were about 2.5 cm

suprith_badarinath_md Mammograms have been controversial for years, since it is a technology with limitations. The best screening is done with the multidisciplinary cooperation between radiologists, and the examining doctor. Even more careful followup is done if there are abnormalities seen.

alymae but the problem i see most of all with all this is the cost, i have no insurance, so i called jeannie and she set me up for one, i had it 4 mths ago and got a clean bill, it scared me even more with my mom having it

alymae try to get a mamo during moth of october.... they are booked solid

suprith_badarinath_md There are mobile mammogram units in town that do offer screening mammography for people without coverage.

alymae is it true that braest cancer & ovarian are hand in hand especially if both run in family

alymae breast

suprith_badarinath_md Yes, breast and ovarian cancer are associated risks for people with a mutation of the Brca gene. Genetic testing for Brca is offered for people with breast cancer and a strong family history or very young people with breast cancer. If an abnormal gene is found, we can then screen the family.

alymae where can i be tested for thr brca gene, is there funding for low income ppl

suprith_badarinath_md Brca testing can be performed at many places in town, including at our office, but is best performed on someone with breast or ovarian cancer.

LINDA My Daughter , recently found out out she has a rare form of breast cancer, they told her on her 29th Birthday, the hospital did not want to do a mammogram, because of her age

alymae i am waiting to get a shands card, going to get a ca125 test ( i think that is it) , i am in that high risk group, tried to get a hysterectomy there a cpl yrs ago but that wont do it, i have hpv , so you can imagine what my yearly intails

alymae entails

alymae sorry to hears that linda

alymae linda they did the same to my sister at 18

suprith_badarinath_md Linda - the problem with mammongrams in younger women is that the images are not very useful when breast tissue is dense, as it is in younger women. Mri and ultrasound might be more useful to follow a mass.

LINDA Dr.badarinath, what excatly is Sguamos cell caricioma?

suprith_badarinath_md Squamous carcinoma is a tissue type of cancer rarely found in the breast. More often we see this in lung, throat, and other smoking related cancers. This tissue type is also seen in skin cancers

LINDA yes they can not find the source where it came from, that is why they said it is so rare, in the breast

FJ How and when do you know you have a false possitive?

suprith_badarinath_md A false positive is when a screening test shows an abnormality, but a biopsy shows that it is not cancer after all.

bparker When should I start having mammograms since my grandmother had cancer,i was diagnosis with fibro cysic at age 19 an my mom has had some issues?

FJ But what is wrong with that? If a woman has a biopsy? does that ruin her assthetics

suprith_badarinath_md One of the reasons the Us Preventitive Services Task Force gave for recommending against mammograms for ages 40-50 was because of the false positives that lead to biospies that find no cancer.

mandaringrandmother In 2006 I had 3 biopsies done with 2 of them came back inconclusive and the 3rd was cancer free. Yet, the specialist had me do mammograms every 3 months for the first year, then every six months and now every year. I get a letter from the cancer registry of the hospital with reminders yet I don't think I was ever diagnosed with it.....why is that? I had 4 doctors that initially said I had Inflammatory breast cancer by sight and said only a biopsy could tell. I had a portion the size of an egg removed twice six months apart....my breast was the size of a cantaloupe and I only weighed 140 lbs - 5ft 4 inches.

suprith_badarinath_md Any surgical procedure has Some risk. Also, once someone has a biopsy, there is some scar formation that leads to abnormalities seen on mammograms. So a woman will get more tests and possibly more biopsies, all without actually having cancer.

LINDA what are the chances of survial, with Sguamos , in the breast, they are going to start a very high, agreesive form of chemo next week, hoping to shrink the tumor, before surgery

FJ my wife had a mammogram at age 40 and was saved from a grade 1 cancer, If she had not had that Mammogram, she might be dead now~!

Sylvia Can a fall landing on the breast and bruising it lead to cancer in that injured breast?

Chihuahua_mom Dear Doctor: Why do they not use Mri or better technology than mammogram's, to screen and diagnose breast cancer? I have Ms and get Mri's on a regular basis and the Mri technology seems far superior to mammogram's? thanks!

suprith_badarinath_md Mammography has clearly found many cancers in early stages. What the researchers are trying to figure out, is, how many woman are better off finding the cancer on mammogram compared to the woman finding the mass on her own, or on a routine doctor exam.

mandaringrandmother Doctor.....the 3 biopsies were done within 3 weeks before surgery....i am also 54 years old. I also still have pain......could that be from the mass infection the doctors said I had. The cyst/tumor had ruptured and my breast was huge....they did these biopsies because they said they didn't want to do surgery until they were absolutely knew for sure what it was. Is it really necessary for me to followup anymore since my final biopsy came back o-k???

grace I am 31 years of age, and i do not have a family history of cancer. Now my question is do you recommend a test for my age and history

suprith_badarinath_md Mri is a wonderful technology that uses no radiation. It shows such great anatomical detail, that there is a clear increase in false positives. The lower the breast cancer risk of the woman tested, the higher the chance that a biopsy will be recommended and no cancer will be found.

suprith_badarinath_md Currently the risk of developing breast cancer is about 10% by the time a woman reaches 90. The perfect screening test will find all the cancers and not ring any false alarms. We don't have this test yet.

Mary Isn't thermograpy a safer, less invasive, cheaper, and more effective way to detect breast cancer?

suprith_badarinath_md Before the age of 40, unless there are special risk factors, no specific screening is recommended. The risk of breast cancer under the age of 40 is very low.

suprith_badarinath_md Sorry, I am unfamiliar with thermography.

grace ok thank you

suprith_badarinath_md There is a new technology called Pem (positron emission mammography) related to Pet technology, that may, in the future, be part of our routine screening. Currently it is approved only for patients who already have breast cancer. It is much too soon to know if this will really make screening better.

kciesla376 Dr. B, What are the recommendations for women over age 75?

suprith_badarinath_md There is no data to make recommendations above the afe of 75, because the studies did not include these people. However, the increasing breast cancer risk, and less dense breasts in this population make these women the ideal group for screening mammograms.

a4greymom What is the newest screening technique available? I have heard of a new way of scanning at Flagler Hospital, and that it is much less invasive and more modest and comfortable the the current way. Is this an option and how much better is the newer way as opposed to the current way?

suprith_badarinath_md The flip side of screening older women is that many of the cancers these women develop are less aggressive, and it is possible that finding a cancer earlier may not save lives. In other words, slightly larger cancers in older women may be just as curable as those found earlier.

suprith_badarinath_md Digital mammography is a newer mammography. There is not really any other established technique, but other tests like ultrasound and Mri can clarify what we see on the mammogram and give a more accurate conclusion.

suprith_badarinath_md a4greymom: do you know what this test is called?

Sylvia I am 65 and have been diagnosed with fibrocystic disease of the breast. About 6 months ago I had two lumps in the breast and they were drained; no cancer. I recently had an awful on that same breast resulting in the breast being bruised. Can this injury lead to cancer?

Sylvia forgot to say an "awful Fall"

Mary This is an explanation of thermography:

a4greymom No, my daughter is a surgical nurse, and heard that this technique involves a scanning techinques that moves around the body instead of the current uncomfortable technique, is this possibly the Mri you are talking about??

suprith_badarinath_md Fibrocystic disease is challenging to manage because there is some increase in cancer risk, but we have to be careful not to jump to biopsies too often. To my knowledge biopsies and minor trauma does not cause a breast cancer.

Mary Dii uses ultra-sensitive medical infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution images of these temperature variations. Because of Dii’s extreme sensitivity, these temperature variations may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast

Sylvia Thank you, Dr.

a4greymom Sorry, more, the patient holds arms upright in the air, and the machine moves around her, again, maybe and open Mri??

suprith_badarinath_md Mri involves lying on the belly on a special support. Then the patient is slid through the Mri machine. Open Mri machines tend to have blurrier images.

daleeff Is it true that most breast cancer is not painful?

a4greymom thank you.

suprith_badarinath_md I would be skeptical of Dii or thermography because I would worry about the risk of false positives. Functional imaging based on burning energy would likely be more accurate that simply looking at minor temperature variations, but we need to see what the research shows.

suprith_badarinath_md It is true that most breast cancer is not painful until it becomes large. It is also true that most breast pain is not from cancer.

daleeff Thank You Dr

Mary Go on the web and research thermography. It is extremely effective and economical.

Sylvia Every time I go for my annual mamo the technician asks me if I have always had inverted nipples. What does having inverted nipples represent?

suprith_badarinath_md I will be honest in telling you that these new recommendations are as troubling to us oncologists as it is to the general public. The Task Force made these recommendation changes not because mammograms are bad, but over concerns that they are not good enough to do for women 40-49 and to do every year for women 50-75. However, mammograms still showed survival benefits across age groups.

daleeff Dr Mahagen (spelling) is a great oncologist in Jax he is next to memorial hosp

jmelfi Which guidelines do you recommend? The new or old?

suprith_badarinath_md Inverted nipples can be a sign of a breast mass. If a mass grows in the breast, it can pull on the connective tissue and ducts and pull the nipples inward. However, if somone's nipples have always been that way, this concern does not apply.

daleeff I've had the fibro cyst all my adult life and had dozens aspirated and one huge one removed, after my first find I seeked a second opinion due to my Dr wanting to do a mastectomy. Second opinions are a great thing

a4greymom So as women, what do you suggest we do? Listen to the Task Force, an reputible oncologist, or just sit back and make our own decisions???? Not good enough. Another wrench thrown into the gears.......

daleeff my husband had lung cancer in 1991 the surgeon said he would be dead in a year even with treatment then the oncologist stepped in and took care of him, he is still alive

suprith_badarinath_md We are still sticking with the traditional recommendations of annual mammography. However, people need to be aware that there is the chance of a false positive for younger women, and there is not clear evidence that annual mammograms are definitely better then mammograms every other year. This might change when we get studies with digital mammography and other advanced technology.

jmelfi Thank you.

daleeff a4greymom keep doing the mammos and self exams just like we have the past 20 yrs

Sylvia I have had fibrocystic disease most of my adult life, had some aspirated and had to have surgery to remove some. None were cancerous. I plan to use my own judgement and continue to have my annual mamo and sonograms/ultrasounds. It's my body and my life, so I would suggest everybody to not pay any attention to the task force findings/recommendations!!

daleeff people that have cancer in the family really need to ignore this panel, preventive can save your life

suprith_badarinath_md In the future we need to have more individualized guidelines, so we can have more accurate screening. Until then I would stick to annual mammograms.

daleeff sylvia Amen!!

suprith_badarinath_md Daleef. Good point. People with a strong family history of breast cancer (especially someone diagnosed under the age of 50) are not the "typical" population that the guidelines are meant for.

daleeff Dr when chemo is necessary why don't oncologist prescribe Marinol for nausea more often?

daleeff Marinol is expensive but taken properly does stop the vomitting, I gave my husband two every 4 hrs and he never vomitted again

suprith_badarinath_md With these guidelines in place, if a woman has a negative mammogram and wants to go every two years instead of every year, she should not feel guilty. Mammography is still associated with improved survival, but it is not clear that every year is the best timing. More often than each year is probably unhelpful.

suprith_badarinath_md Marinol is useful, but not everyone needs it. Our recent experience is that less than 15% of patients on chemotherapy vomit with the "standard" anti nausea meds. Some of our older patients don't like how they feel on marinol, but for some patients this drug works great.

suprith_badarinath_md Thanks, for all the great questions. I hope that I was helpful to some people.

daleeff Thanks you, with my husband none of the anti nausea meds worked so I asked for Marinol. We almost lost him a few times due to loss of fluids

suprith_badarinath_md To daleeff: There is nothing like the experience of caring for a patient with advanced cancer. It requires you tap into all your strength.

suprith_badarinath_md Good night

daleeff good night and thank you for being here

daleeff please ladies do self exams and get those mammos

daleeff don't forget the arm pits too

daleeff btw evenn males need to do self exams they can get breast cancer also