NEW BREAST SCREENING GUIDELINES FROM YOUR LOCAL EPIDEMIOLOGIST

Posted on May 15, 2024 by John Bailey

New breast cancer screening guidelines. Younger Women Should Get Screened

What changed and why

ANDREA BETTS AND KATELYN JETELINA

MAY 15

(Reprinted with permission)

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Screening guidelines for breast cancer have recently changed, and vaccines are in the works.

Here’s the news! And, more importantly, the “why” so you can make evidence-based decisions.

Last week, the U.S. Preventive Services Task Force (USPSTF, volunteer panel of national experts) released new guidelines for breast cancer screening: Younger women should get screened. Specifically, those assigned female at birth who are at average risk of breast cancer should get a mammogram beginning at age 40 and ending at age 74. (NOTE: Guidelines are different for high-risk women, such as those with family history or genetic predisposition. Not sure? Try this risk assessment tool.)

The science around who should get screened for cancer and how often is always evolving—in part because technologies and patterns of cancer continue to change.

Policymakers are charged with routinely weighing the evidence on benefits and harms of screening. Detecting a cancer early can potentially make a huge difference in prognosis and burden of treatment, but it can be hard to demonstrate what didn’t happen. Potential harms include false positives and treating “pre-cancers” that wouldn’t necessarily have becomes a problem (called overdiagnosis) and the related physical, psychological, and financial impacts. This benefit/harm balance has been debated for years, mainly because of the uncertainty of numbers (e.g., lives saved vs. overdiagnosed).

Before the recent change, USPSTF recommended starting screening at age 50, which was controversial and disagreed with a number of other organizations. For example, the American Cancer Society (ACS) recommended everyone start screening at age 45.

Several factors drove UTPSTF to recommend screening at younger ages:

Breast cancer is increasingly occurring at younger ages. It’s estimated breast cancer in people under age 50 has increased by 2% each year, and more rapidly in recent years. Breast cancer is typically more aggressive when it occurs in younger people (before menopause in particular). Because cancer has typically been thought of as a disease of aging, younger people often don’t discover cancer until it is more advanced.

New Breast Cancer Cases Among US Women Aged 20 to 49 Years, 2000-2019. Figure Source: JAMA Netw Open. 2024;7(1):e2353331.

Technology improvements such as 3D mammograms have made screening more effective in identifying cancers. This is important because it reduces overdiagnosis and the psychological distress related to an abnormal result. We are curious to see how AI can help with this, too.
For example, a Lancet study showed a modest increase (4%) in cancers detected when a radiologist+AI looked for cancer on a mammogram compared to two radiologists.

Strikingly high breast cancer mortality among Black women, in particular, could be reduced by earlier screening. A recent study projected that beginning cancer screening at age 40 would reduce cancer deaths among Black women by 24%. This is crucial since Black women have higher mortality from breast cancer than women of other races or ethnicities.

Although the ACS and USPSTF now agree on younger screening, they still disagree on some specifics, including how often to screen. USPSTF recommends doing so every other year, while ACS recommends an annual mammogram once you’re 45. (The American College of Obstetricians and Gynecologists, or ACOG, lands in the middle.)

This is a problem. Conflicting recommendations create confusion, leading to population-level patterns of delay. In addition to absolute benefits and harms, policies and guidelines should incorporate evidence on human behavior (AKA behavioral science). For example, preventive health behaviors are easier when guidelines are clear, behaviors are simple, and the timeframe is reasonably narrow. I can probably remember when it’s been about a year since my last mammogram, but two years? This shifts more burden to the health system to track my mammograms and remind me.

Even if detected early and treated, some cancers can recur or spread and, in the process, mutate to become more resistant to treatment. This stubborn process has driven scientists to try and develop vaccines to prevent and/or achieve durable “immunity” to cancer.

One form of breast cancer called triple negative breast cancer, or TNBC, is more difficult to treat because there are fewer “targets” for currently available drugs. The Cleveland Clinic has been working on a breast cancer vaccine for 20 years that trains the immune system to identify and destroy TNBC cells, which secrete a protein called alpha-lactalbumin.

Preliminary results from the first portion of the phase I clinical trial were presented in April 2023. The scientists enrolled TNBC survivors who were at risk of their cancer returning.
The purpose of this trial was to test safety, but scientists also looked at immune responses. All participants built some immune responses, and the vaccine was safe.

There’s a long way to go to show an impact on TNBC, and many larger breast cancer vaccine trials have failed to get a vaccine to market. Still, we’re keeping an eye on this space, and keeping our fingers crossed.

Get your mammograms starting at age 40. It’s likely easier (and more proactive) to do it every year, but you can weigh the potential benefits and harms for yourself.

Love, YLE and AB

Andrea Betts, MPH PhD, is a behavioral scientist whose research focuses on cancer in adolescents and young adults.

“Your Local Epidemiologist (YLE)” is founded and written by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife. During the day, she is a senior scientific consultant for several organizations, including CDC. At night, she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:

TONIGHT SCHOOL BOARD FORUM REBROADCAST AT 7 ON FIOS CH 46 AND OPTIMUM CHANNEL 77

Posted on May 13, 2024 by John Bailey

THE BIG 8 IN THE BOARD OF EDUCATION RACE FOR 3 BOARD SEATS. WHITE PLAINS LEAGUE OF WOMEN VOTERS FORM REBROADCAST. MUST-SEE TV

SUMMER PLANS OUTBREAK OUTLOOK NORTHEAST

Posted on May 13, 2024 by John Bailey

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Summer Plans + Outbreak Outlook COVID HOSPITALIZATION REPORTING END

Northeast edition

bY Dr. Caitlin Rivers

(Reprinted with permission)

MAY 13

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Welcome to the Northeast edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe now button below. Thanks for reading! -Caitlin

Important note: As summer approaches, the availability of data on respiratory diseases has dwindled. Influenza-like illness reporting is paused in most states, and Covid-19 hospitalization reporting has ended. This means there is less for me to cover in Outbreak Outlook. While I plan to continue to provide weekly updates for paid subscribers, I’m going to put them into a single report rather than the usual four regional reports for the summer months. Expect these updates to be less detailed until the fall when regular data collection and reporting resume.

Influenza and influenza-like illness is taking its summer break. Very few people are ending up at the doctor’s office or other outpatient clinical settings for influenza-like illness.

New Jersey has been reporting rates noticeably higher than its neighbors for the past several weeks (3.09% compared to <1.75% in every other state in the region), but I expect it to catch up in the next several weeks.

Spotlight on New York: Influenza-like illness at the state level is very low at 1.1%. There was a slight increase in the Western part of the state, but still below 2%. ILI in the city is quite a bit higher at 4%, but it is declining (slowly).

Northeast Region: Change in ILI Activity

Percent of doctors visits for ILI symptoms

Similarly, very few people are being hospitalized for influenza in the Northeast. Two Northeastern states contribute to the CDC’s sentinel surveillance: Connecticut and New York. Connecticut reported 0.4 influenza-related admissions per 100,000 population, and New York reported 0.7.

Hospitalization data looks a bit different this week because, as of May 1, hospitals are no longer required to report Covid-19 or influenza hospital admissions. While they can report voluntarily, this past week ~1% of hospitals in most states did so. As such, the data presented here are from the CDC’s sentinel surveillance network (RESP-NET) that pulls from a subset of hospitals in a sample of states and covers ~10% of the U.S. population.

The quiet spell continues with Covid-19, with low levels in the wastewater, and few people ending up in the emergency department or hospitalized.

Wastewater data show very low concentrations of Covid-19 in the Northeast. Covid-19 is sending very few people to the emergency department – Covid-19 accounts for <0.5% of ED visits across the Northeast (the CDC categorizes anything <1.5% as “minimal”). Hospitalizations for Covid-19 similarly remain quite low in the Northeast, with the two states that contribute to the CDC’s sentinel surveillance network (Connecticut and New York) reporting that they admitted between 1 and 2 cases to the hospital per 100,000 population

Wastewater concentration by region. Source: CDC

Some good news! There was a nice drop-off this past week in test positivity for norovirus in the Northeast, down to roughly 8% from around 10% the week before.

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New

Yogurt covered pretzels by Western Mixers Produce & Nuts, Inc. (more info)
White-coated candy sold by Palmer Candy Company of Sioux City, Iowa (more info)
HyVee Cream Cheese (more info)

Previously reported:

Planters Honey Roasted Peanuts and Deluxe Lightly Salted Mixed Nuts (more info)
California Shelled Walnuts, Organic Light Halves and Pieces (more info)
Ground beef by Cargill (more info)
Trader Joe’s 50% Less Salt Roasted & Salted Whole Cashews (more info)
If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.

A nurse in upstate New York has been accused by the New York State Department of Health (NYSDOH) of falsifying vaccine records for 116 children, involving nearly 550 vaccinations. Operating out of “Surviving Naturally” in Monroe County, the nurse allegedly submitted false data to the New York State Immunization Information System (NYSIIS) from July 2019 to February 2021. She reportedly claimed to have administered vaccines that were never given, leaving children unprotected against diseases like measles, chickenpox, and polio. The NYSDOH has fined the woman $55,000 for her actions and permanently barred her from the NYSIIS.

TRAIN VS CAR AFTER CONGESTION PRICING BEGINS

Posted on May 13, 2024 by John Bailey

TRAIN $49 CAR: $79

The METRO NORTH EXPRESS TO GRAND CENTRAL, 10:37 A.M. arrives. Our engineer was a woman and she rattled off the stations on the line to come with the nostalgic rat-a-tat delivery of conductors of old, crackling “next stop Hartsdale, Scarsdale, Crestwood change to Bronx and South, 1-2-5 and Graaaaand Central” This excitement in her voice thrilled me with the drama of a train, and she eased her No. 6 gently to stops and on the glide into 111 year old Grand Central she babied the big train into Track 105 to a whisper stop. NO squeak. Positively flawless train engineering. Breathtaking.

The Number 6 (BMT) Subway, roaring in. (MTA photo)

WPCNR TRAFFICA. News & Comment By John F. Bailey May 13, 2024:

Brenda Starr and I took in a matinee Saturday with friends from Long Island and learned just how much congestion pricing would cost us vs taking the train into The Greatest City in the World would cost us, as well as the environmental experience.

The bottom line: paying the $15 congestion tax scheduled to start July 1, at whatever entry we choose to enter Manhattan Central Business District by our car would cost us $79 for a Saturday trip while taking the train from White Plains on a Saturday would cost just $49, a $30 saving.

Here is our cost for two going in by train Saturday from White Plains to Grand Central and subway to Bleaker Street:

Parking White Plains Station Parking Facility: $9.75

Round Trip to Grand Central Weekend (2 Persons): $26

BMT SUBWAY N0.6 TRAIN 2 PERSONS TO BLEECKER & BACK: $13.00

Total : $48.75

Cost to Drive from White Plains to Bleaker Street and Parking

CONGESTION TOLL: $15.00

SPUYTEN DUYVIL BRIDGE: $4.00

GARAGE PARKING: $50.00

GAS (35 MILES) $10.00

TOTAL CAR: $79.00

The train trip saves you $30 over driving your once the Congestion Pricing starts.

42ND STREET OLD BMT TILES OF THE PAST–LOOK FOR THEM.

BLEECKER STREET STATION TILES SPIFFED UP SO OLD NEW YORK BRAND NEW

It saves you the aggravation and danger of the Hutchinson River Parkway, Cross County Parkway and Henry Hudson Parkway, Spuyten Duyvil Bridge onto the West Side Highway and stress of New York traffic.

The railroad is a clean and scenic ride and treats you to the scenic whisk of an express into Manhattan. You then take the subway uptown or downtown for 3.00 a person with the convenience of credit card tap on the turnstile, followed by the high energy rumble and roar of the greatest subway in the world enabled New York to grow. The cars are cleaner, ride swift, and the antique and nostalgic subway stations regale you with tile designs, explicit signs to look at.

The subways are not good if you are disabled. Hard to find elevators. Entrances from the street level for your return uptown or downtown are stairwells.

And you emerge from the subway into the chock-a-block dazzle of the New York modern with the New York classic architecture. From tenements to majestic exterior designs of century old buildings whose architectural features set your heart soaring with their beauty and whimsy.

Nothing I have ridden on thrills me more than the New York City “Subway In a Hurry!” It takes you new worlds! Better than a roller coaster.

Congestion Pricing will be recorded by gantry at whatever entry we choose – exits off the West Side Highway beginning at 60^th Street will all have overhead gantries to electronically record E-Z Pass equipped cars, trucks, and vehicles subject to the toll departing the West Side highway at 59th Street. The 59^th Street Bridge, Manhattan Bridge, and Williamsburg Bridge, Lincoln and Holland Tunnels and Brooklyn Battery Tunnel are subject to tolls. Previously the bridges were free.

This MTA website explains who pays, and discount plans here:

https://congestionreliefzone.mta.info/tolling

Photograph of the Day: The Mother’s Day Rose to all Moms Everywhere especially Mine

Posted on May 12, 2024 by John Bailey

FIRST ROSEBUD OF THE SPRING ON MOTHER’S DAY WEEKEND

The Azalias Tough Loving Like Mom

Posted on May 12, 2024 by John Bailey

Mom: The Azalea

Like Mom they are always there always.

An azalea like mom is always with you.

No matter what the cold bitter days,

The happy joyous days the melancholy Dismays.

The Azalea like Mom conquers and lasts.

Endures personal disappointments.

Rejoices in smiles and hugs in your achievements

Mom The Azalea always comes back in Spring’s presence.

She blooms in cheer brightening life’s drear.

She withers in endless rains but as flowers fade

Her summer’s green cheer grooms recalls summer shade

As fall days shorten and leaves fall in colorful cascade.

As child turns to adult and drifts away from Mom The Azalea

Building life of the unknown, the unexpected, the joyous day

The crushing losses, the proud triumphs, the mistakes along way,

Mom The Azalea in winter green and loving Mother’s Day softens what be May

The Azalea resplendent in sun and rain this time of year

Reminds you of your mom, the clean-up-your-room Mom.

The fashion mom always enduring unfortunte fashion whims

The always-accepting-coping-solution mom ready with the elizir.

Sweeping through your life even through her life’s essence

No longer manifests, Mom, like The Azalea is omnipresent

There in bloom lifting life’s gloom, her wise advice echoing

Calming your mind anxiety, with you like God to rely in deciding.

From a mother’s first sight of you being born to your grief

When her presence departed but now is your companion still

A voice of past and present in future with you with steadfast belief

In you, your promise, ability, courage dispensing wisdom and will.

As I write this about my mother, from her cross “Johnny Bailey!”

Or my wife’s mother’s, “Oh dear God, Janet” when Janet misbehaved

Their wisdoms, homilies, and dedication to their children who are old

Is forever there to draw new courage, new wisdom untold.

Mothers are always remembered even when we are unable to go to

The Old Kittle House for a Mother’s Luncheon today in that old white table cloth dining room

Overlooking the immense green on a sunny day.

With Dad in white shirt and tie, children in suits and dresses

This stanza does not rhyme because The Mom The Azalea

Influences, helps, always she loves us.

Thanks Mom. You were my first teacher. My first love. I so admired you

Never knew how much until now.

You’re not gone. You are not a memory. You are a presence in my life always

HEY MOM!

Posted on May 12, 2024 by John Bailey

(This is for all you Moms out there. We know what you go through!) “HEY MOM!” Hey Mom– Bring me two waters so I’m set? Where’s my underarmor? And my visor? Are my tights washed? My skates are dull. Hey Mom, can you call the advisor? Hey Mom, I wasn’t yelling at you. I didn’t mean to! You were yelling at me! You never let me do anything my friends do Hey Mom, would you chill, lighten up, just do! Hey Mom, I don’t like the way this looks for the prom – I don’t like the color, how could you think this was me? I just can’t wear this, it’s this, it’s that it’s…Oh, Mom!?! Hey Mom, I’ve been studying all morning getting knowledge. Can’t I go out, I’ll be back by ten? But, I know the material, gone over it again and again. Oh, Mom – I hate my life! I can hardly wait until college. Hey Mom – But I did call and let you know Don’t you understand, I couldn’t call at that time. No, you can’t not let me go – it’s a great band Oh, Mom – I hate you! You never understand! Hey, Mom, please don’t embarrass me at the game By screaming so loud, it’s just so tacky But, hey mom, I like that you’re over there in the stand Watching me play, you know that don’t you Mom, you understand? Hey Mom, can you get me to the rink At 5 – I know you have to take off from work early? Thanks, Mom, I’m so sorry but the team has a special thing I have to be there, thanks Mom – I love you—really. Hey, Mom, please when you pick me up at the dorm Don’t come inside. Just wait outside, call me on the cell I’ll be right down — it’s the norm. Don’t ring the bell! Hey, Mom, I’ve read the classifieds There are no jobs, I can’t make all those calls. Well, OK, I guess I can send that resume you made for me (sigh). OK, I’m lost, where’s the post office, down Lexington to what? Hey Mom, well I’m bringing my friends by, Don’t let Dad embarrass me with his jokes, OK? I’ll just die if he’s silly again — you won’t let him do that? You’ll talk to him about that? All right, Mom I’ll take that extra course. But I’ve just been going to school for months it never ends! Can’t I have a little vacation, I don’t know what’s worse Can’t I spend a little time with my friends? You do like him, Mom? Oh, I hoped you would. Yes, I really do I am so glad you do too! Hey Mom, can you take care of the kids this weekend? We’re going to Vermont with a friend. And Mom, the cats get kibble in morning and meat at night, We love you mom, sorry for the short notice, talk to you tonight. Hey Mom, I’m sorry I can’t see you Mother’s Day. Are you all right, what will you be doing today? Going to a play – great – you know we love you in every way? Though we may not show it you’re always with us even when you’re away.

A FEINER FIND: OPENING TODAY: “WOOPS! MACAROONS AND GIFTS” AT THE WESTCHESTER WHITE PLAINS NY USA

Posted on May 11, 2024 by John Bailey

WPCNR THE LETTER TICKER fROM PAUL FEINER MAY 11, 2024

Edgemont resident Sylvia Emmer was a guest on my cable TV show and discusses her new business Woops! Macarons & Gifts.

https://youtu.be/iwU-ZnrH2ks

Woops! Macarons & Gifts Westchester, offering delectable macarons and charming gifts, is having its grand opening celebration on Saturday, May 11 from 2-4pm (just in time for Mother’s Day!).

The boutique kiosk offers a wide variety of French macaron flavors, including classic favorites and seasonal specials, such as birthday cake, red velvet, cookies and cream, blueberry cheesecake, and honey lavender. Customers can also explore beautifully packaged macaron gift boxes, perfect for any occasion.

LOCATION:

The Westchester Mall

125 Westchester Ave.

White Plains, NY 10601

The kiosk is across from the Apple Store on Retail Level 3

Mall parking garage entrance closest to kiosk: 62 Westchester Ave., White Plains, NY

COFFEE WITH WHITE PLAINS WEEK SATURDAY 8:30 A.M. THE DEC 10 “CITY BUDGET REPORT” ON FIOS CH 45 AND OPTIMUM CH 76 & WWW.WPCOMMUNITYMEDIA.ORG

Posted on May 10, 2024 by John Bailey

THE CITY PRESENTS, DEFENDS $212 MILLION 2024-25 BUDGET

THE WHITE PLAINS LEAGUE OF WOMEN VOTERS SCHOOL BOARD FORUM FULL HOUSE. CRACKLING DEBATE

PLAYLAND OPENS MAY 18

WHITE PLAINS IN THE MONEY SALES TAX DOLLARS SURGE–9% AHEAD THROUGH 9 MONTHS

GHOST GALLERIA TRANSIT DISTRICT SCOPING DOCUMENT CLEARS COMMON COUNCIL

LEXINGTON AVENUE EYED FOR WIDENING TO RELIEVE WHITE PLAINS HOSPITAL AREA TRAFFIC CONGESTION

JOHN BAILEY AND THE NEWS

THIS WEEK AND EVERY WEEK

ON WHITE PLAINS WEEK

23 YEARS ON THE AIR

ROCK THE BLOCK IS GOIN ON

Posted on May 9, 2024 by John Bailey

en Español

Downtown White Plains Business Improvement District is so excited to launch Rock the Block, their new signature summer concert series. Think: FREE Wednesday night live music (2nd Wednesday of each month through August), street closed to traffic and open instead to outdoor dining, family fun, yard games (badminton, ping pong or cornhole anyone?).

Eight restaurants will pull out all the stops with outdoor dining, expanding their serving area into the road bed of Mamaroneck Avenue between Maple Avenue and Post Road. The Arts Mobile will be there too, delivering fun to youth in attendance with an activity to craft handmade maracas! Don’t miss “La Playa,” our own answer to the Mexican Rivera. We’ve found a workaround to get you a palm tree and sand beach fix, right in the heart of White Plains. Just throw on some shades and pretend you’re on vacation, sans a flight!

Hope to see you there!

en Español

El Distrito de Mejora de Negocios del Centro de White Plains está muy emocionado de lanzar Rock the Block, su nueva serie de conciertos de verano distintiva. ¡Imagina: música en vivo GRATIS los miércoles por la noche (el segundo miércoles de cada mes hasta agosto), calles cerradas al tráfico y abiertas en su lugar para cenar al aire libre, diversión familiar, juegos de patio (¿alguien para jugar al bádminton, ping pong o cornhole?).

Ocho restaurantes sacarán toda la artillería con cenas al aire libre, expandiendo su área de servicio hacia el lecho de la carretera de la Avenida Mamaroneck entre la Avenida Maple y la Calle Post. El Arte Móvil también estará presente, entregando diversión a los jóvenes asistentes con una actividad para crear maracas artesanales. ¡No te pierdas “La Playa”, nuestra propia respuesta a la Riviera Mexicana! Hemos encontrado una solución para ofrecerte una dosis de palmeras y playa de arena, justo en el corazón de White Plains. ¡Solo ponte unas gafas de sol y finge que estás de vacaciones, sin necesidad de tomar un vuelo!

¡Esperamos verte allí!

WHITE PLAINS CITIZENETREPORTER SETS RECORD VISITS FOR YEAR 7,017,658 VISITS! 2,098,003 VISITORS MADE 6 VISITS A DAY EVERY DAY. 63,330 UNIQUE VISITORS MADE 133,730 VISITS IN DECEMBER. WPCNR AVERAGED 17,284 VISITORS A WEEK, VISITING 31,270 TIMES.

NEW BREAST SCREENING GUIDELINES FROM YOUR LOCAL EPIDEMIOLOGIST

New breast cancer screening guidelines. Younger Women Should Get Screened

What changed and why

The age to start screening is now 40 years old

How often to screen is up for debate

Breast cancer vaccines?

Bottom line

TONIGHT SCHOOL BOARD FORUM REBROADCAST AT 7 ON FIOS CH 46 AND OPTIMUM CHANNEL 77

SUMMER PLANS OUTBREAK OUTLOOK NORTHEAST

Summer Plans + Outbreak Outlook COVID HOSPITALIZATION REPORTING END

Northeast edition

Summer Plans

Respiratory Diseases

ILI

COVID-19

Stomach Bugs

Food recalls

In other news

TRAIN VS CAR AFTER CONGESTION PRICING BEGINS

Photograph of the Day: The Mother’s Day Rose to all Moms Everywhere especially Mine

The Azalias Tough Loving Like Mom

HEY MOM!

A FEINER FIND: OPENING TODAY: “WOOPS! MACAROONS AND GIFTS” AT THE WESTCHESTER WHITE PLAINS NY USA

COFFEE WITH WHITE PLAINS WEEK SATURDAY 8:30 A.M. THE DEC 10 “CITY BUDGET REPORT” ON FIOS CH 45 AND OPTIMUM CH 76 & WWW.WPCOMMUNITYMEDIA.ORG

ROCK THE BLOCK IS GOIN ON