I voted AND had my first mamogram!

[Brandi]

I was so nervouse about getting a mammogram and I have to say it was no big at all for me. A bit wierd. And I did feel like they were being handled a bit roughly but it was really not painful at all. Like I said just odd. I guess if you have sensative breasts then I could see why it would painful. I am glad I did it! and they gave me a rose. I got a cup of starbucks tea for free today too for voting!

[Zen]

Mine hurt like hail. Teats in a vise is what it feels like to me :eek:

[BleeckerSt_Girl]

Mine hurt like hail. Teats in a vise is what it feels like to me :eek:

Same here. I hate it, and it hurts.
But I have mine scheduled for tomorrow anyway. :o

[evangundy]

I get mine in about 3 weeks. I consider this one of life's "necessary evils". It only hurts for a little while and you get chocolate afterwards at our clinic :-)
Edna

[snapdragen]

I've been getting them since I was 34 -- sometimes they hurt, sometimes they don't. I think it depends on the technician.

I'm due for one, but I'll wait until the neck collar comes off. :rolleyes:

[Aggie_Ama]

Kudos to you Brandi!

Haven't had one but when I need one I will schedule it promptly. I will also have my first colonoscopy the week I turn 40. What is worse breast cancer or the mammogram? Colon cancer or the colonoscopy? Having seen two of the dearest men in my life fight colon cancer I will take the scope anytime. I guess I will never understand why people play Russian Roulette with their health over temporary pain or discomfort? :confused: :o

[Pax]

I hate em, I've had breast reduction surgery and having the scar tissue smashed is ridiculously painful. :(

[oxysback]

I started getting mamos at 35 because my mom died of breast cancer. I remember being really, REALLY nervous the first time, but it ended up to be no big deal.

As Aggie says...I'd rather have my boobs squished for a little bit and maybe actually LIVE through cancer if I get it, than not have any advanced warning at all.

[SadieKate]

I hate it but I do it because I have Fibrocystic Breast Disease (and 3rd generation in my family with it and I was diagnosed at 22 yrs old). The pull on the muscles in my neck is very painful and the last time the idiot tech grabbed my left arm and yanked it into position before explaining what she was doing, followed by an audible popping sound and me exclaiming OW! To which she told me I should have told her I had an injury. :rolleyes: Well, I didn't have one before her assault.

I should have immediately notified the hospital but didn't because I didn't realize how much damage she did. Here I am almost two years later intermittently participating in the PUP thread -- all due to her incompetence.

Just make sure you don't let the techs do anything without explanation first. You'd think this was a no-brainer.

[snapdragen]

sk - after my stay in the hospital, I wonder about some healthcare professionals. All of the nurses (3 shifts) were great, as were the aids, except for one moron. She worked the night shift; came in every hour to take my blood pressure, temperature, and oxygen levels. Could have been done in 5 minutes, except she'd stand around and watch television while in my room. Then she decided to check my catheter, shoving my legs around and pulling at tubes - I yelled ouch. "Oh, these can hurt sometimes, do you need something more for pain?" I looked her in the eye and said "Nothing hurt until YOU started in....."

[SadieKate]

Bad apples in every industry . . . unfortunately, it's hard to escape them in some circumstances. :(

Did I ever tell you about the PT who nearly ripped out a 55mm screw in my knee just hours after it was installed? She was out looking for a new job the next day.

[oxysback]

Could have been done in 5 minutes, except she'd stand around and watch television while in my room.

Maybe she's been watching House too much? :eek:

[emily_in_nc]

Seems like a popular week for mammos -- I had mine Monday afternoon! I have read to schedule them during the first two weeks of your cycle if you tend to have sensitive breasts before your period, and that has been a very helpful tip for me. In fact, I had to reschedule this one from a couple of weeks ago for that very reason. The compression isn't what I'd call comfortable, but when your breast tissue isn't sore and swollen from hormones, it's certainly less of an issue!

[OakLeaf]

What is worse breast cancer or the mammogram? ...I guess I will never understand why people play Russian Roulette with their health over temporary pain or discomfort? :confused: :o

If you really want an answer to that I'll PM you. I did lots and lots of reading this summer :( It's not about whether the mammogram is uncomfortable... it's about whether the benefits outweigh the known harm and potential risks.

[crazycanuck]

I'm confused now..Why is it that they only suggest mammos for women over 50? Do you only have to have a history of BC to have one at a younger age?

[Blueberry]

I'm confused now..Why is it that they only suggest mammos for women over 50? Do you only have to have a history of BC to have one at a younger age?

I think it's over 40 here, unless you have a history of BC. And I think it's risk/benefit (please correct me if I'm wrong), but it is radiation...

CA

[OakLeaf]

I'm confused now..Why is it that they only suggest mammos for women over 50? Do you only have to have a history of BC to have one at a younger age?

In the US, most organizations now say age 40. That's different from the rest of the developed world and I'm not even going to get started about the reasons why. Also, in the US, after 50 women are recommended to get one every year, as opposed to every 2-3 years in the rest of the developed world.

Screening radiology carried out on mass populations with no known risk, signs or symptoms, is different from diagnostic radiology where someone who might be younger would have a mammogram because of a high genetic risk or suspicious clinical signs (lump, discharge, etc.).

The reason they're not supposed to start screening younger is because the radiation can induce cancers, and also false positive mammograms (very common - statistically EVERY woman who follows the screening recommendations will have at least one false positive in her life) lead to invasive procedures. Although biopsies are obviously minor from a surgical standpoint, they're extremely stressful and significantly painful, and they also involve exposure to large doses of radiation to localize the incision and sampling. Pain and protracted stress have their own consequences for physical health. Also, it's hypothesized but not known whether healing after a biopsy can trigger pre-cancerous lesions to build a blood supply and become an invasive cancer, when it might have remained benign if surrounding blood vessels had been left intact.

Because most breast cancers are slow growing, the risk of harm to younger women is just too great to outweigh the benefit of screening mammograms.

(The flip side to that is, because most breast cancers are slow growing, and the treatments destroy heart and lung tissue as well as making life miserable for a temporary period during which a woman isn't getting any younger - is there a real benefit to older women in duration and quality of life? That's a decision that every woman has to make for herself, but personally I'm no longer going to have any screening done unless I first consider what might happen if it's positive, and whether the benefits of treatment outweigh the harm.)

There's lots and lots of information out there, but it can be overwhelming. Anyone who's interested, I'd suggest going to the HON Foundation (http://www.hon.ch/) site (code of ethics for health-related websites - lets you screen out the sites that are covert advertising for drug and imaging companies, as well as the sites that are just patients like me :rolleyes: sharing their personal experiences and opinions) - and search on "breast cancer overdiagnosis" and "overtreatment." If you look at sites that you find by other means, make sure they carry the HON Code seal - and that it's an active link to the HON site, not just a pirated copy of the image.

[Tuckervill]

Thanks for that information, Oakleaf. I tend to think there's so much money tied up in breast cancer prevention that it has become its own industry, one that now may have a vested interest in delaying or preventing an actual cure. Not a conspiracy theorist, but it's informative to imagine what might happen to all the companies selling pink floor cleaners (http://www.target.com/Euro-Pro-Shark-Steam-Mop/dp/B001ASP3S0)if suddenly all the breast cancer in the world was eliminated by a single pill.

Karen

[Pedal Wench]

While some might enjoy the "I don't wanna know what's going on in my body" approach, routine screenings have caught cancers and saved millions of lives. If one of those saved is your mother, your sister, your daughter, or yourself, you might change your perspective. Recommending that people skip screenings that are recommended by their doctors could lead to deadly results.

Everyone should use their own judgement in this regard. Don't let one or two opinions on the internet risk your health.

Spend some time with a few thousand people who are all personally touched by breast cancer. Survivors literally fighting for their lives, children struggling after losing their mothers, husbands and sons trying to make a difference after losing their loved ones. Look in their eyes, and then decide if it's all a scam.

Edit: Only 5 - 10% of breast cancers are considered "hereditary", which means that at least 90% of the cases have NO family history.

[Tuckervill]

No one said it was a scam.

There is a measure of hysteria involved, in my opinion. It's partly the way women do things--many of us get on a bandwagon without much critical thinking. I'm guilty as the next woman in certain aspects. Add in the hyper-marketing of the color pink, and it's almost as if they would like you to think breast cancer is lurking in every breast, waiting to strike the innocent and unscanned. Just the fact that you've suggested that someone called it a scam speaks to the kind of rubbing a person can get for deviating from the official message.

The truth is that heart disease kills six times more women than breast cancer. I'm betting the American Heart Association would LOVE to have the fundraising power of the breast cancer community.

What I am calling for is critical thinking and an informed perspective on the issue for every woman. Not blind trust. Included in that informed perspective should be the real horrors of breast cancer treatment and outcomes, but that should not blind us to the very real facts about the risks of the scanning and treatment, like the ones posted by Oakleaf.

Oh, the other thing I wanted to add: How do you know that someone like myself or Oakleaf, who seem to question the conventional thinking has not experienced breast cancer in a very real and personal way? Just because we had the same experience, doesn't mean we came to the same conclusion.

Karen

[Pedal Wench]

The truth is that heart disease kills six times more women than breast cancer. I'm betting the American Heart Association would LOVE to have the fundraising power of the breast cancer community.



That's interesting. Although one in eight women will GET breast cancer, due to early diagnosis and treatment, many more are now surviving.

I'm not in any way attacking your position - I'm just trying to point out that recommending people skip routine screenings can have deadly results. Read Oakleaf's source, study them, then weigh the opinions, risks and decide for yourself. That's all I was trying to say.

I don't doubt at all that you haven't been personally touched by BC. That's my point. Most people have been, and I feel strongly that early detection is what has saved the lives of most people who've been diagnosed.

Sorry if I'm a bit touchy about this. Found a lump yesterday, getting it looked at today. The thought of just ignoring it is unbearable.

[Tuckervill]

I would never say ignore a lump. I think Oakleaf's point was about routine scanning--weighing the risks and benefits. Which is what we are all saying, eh?

The 1-in-8 figure, if I recall correctly is across a lifetime, which greatly reduces the chance of you or anyone else getting it at any one point in your life. My 100 yo grandmother had breast cancer when she died, but she didn't die FROM breast cancer. I'm not a statistician, so I don't know how to explain it in those terms, but the 1-in-8 figure is more scary than it should be.

Also, the incidence of women dying from breast cancer is going down, and the rate is 1-in-35. That's still less than the women who die from lung cancer.

Because you have found a lump and you might be frightened, I want to share this statistic with you:
The 5-year survival rate for women diagnosed with cancer is 80%. About 88% of women diagnosed with breast cancer will survive at least 10 years.

This kind of statistic was very helpful for me when my son was in Iraq. Someone just said, "Most of them come home unscathed." Good perspective--concentrate on the positive, not the negative. :)

Karen

[crazycanuck]

I shall wait until my lovely dr says it's time to go & have a mammo. That & follow the Breast Cancer Western Australia's recent information campaign that specifically targets over 50's.

I shall not panic and go on my merry way

[OakLeaf]

Oh, boy, I figured that would stir up a @!%#storm :rolleyes:

First of all. (((((PedalWench))))) Praying that your lump turns out to be just a cyst. I DEFINITELY didn't suggest that anyone ignore clinical signs like that. I wouldn't ignore clinical signs in myself, either.

As y'all know, I'm pretty sensitive about this myself right now, so ignore if you want, otherwise my apologies for running on...

I didn't recommend anyone else skip screenings. I was pretty careful not to recommend that.

I did say that with regard to mass screening of asymptomatic individuals, everyone should make her own informed decision (or his informed decision, for gender inclusive and male-specific screenings).

I was honest that my personal opinion is no more reliable than a Novartis ad and that everyone should take both of those for what they're worth.

I recommended that people seek out HON Code certified sources of information, since there are many sites that seem to be professional but are not. I encourage everyone to read medical journal articles rather than consumer oriented summaries, AND to be aware, when reading them, of who sponsored the studies. I encourage everyone also to be aware of who controls the information that well-intentioned doctors rely on. I encourage everyone to be aware of exactly what is meant when doctors use words and phrases like "survival" and "mortality rate." I exhort everyone to be honest with herself that we will all die. There are no "preventable deaths." There are just occasions when life can be prolonged, and that may be a good or a bad thing depending on the quality of life. Most everyone who's owned a pet is well aware of this.

I'd also recommend a little book that doesn't directly address any of this, but is very instructive about human psychology: Sway: The Irresistible Pull of Irrational Behavior, by Ori Brafman and Rom Brafman. Early chapters about loss aversion are really relevant to decisionmaking about medical screening and treatment.

Sorry to go on so long. I just want to be clear that I DO respect everyone's decisions. I would HOPE that their decisionmaking is informed. And if someone reads the exact same sources of information I did and comes to a different decision, I respect that, too.

Hugs again, PedalWench.

[BleeckerSt_Girl]

Just got my mammogram today. I'm 54 and my last one was 3 years ago.
I hate them, they hurt, but I do get one every few years anyway.

Got my first bone density scan as well, as a baseline so it can be compared to another one perhaps many years from now.

I don't get many xrays and I tend to avoid them much more than most people in general, but these were important to me.

[Pedal Wench]

Oh, boy, I figured that would stir up a @!%#storm :rolleyes:

First of all. (((((PedalWench))))) Praying that your lump turns out to be just a cyst. I DEFINITELY didn't suggest that anyone ignore clinical signs like that. I wouldn't ignore clinical signs in myself, either.



Hugs again, PedalWench.

Thanks. Doc gave it a 'wait and see for now', mammo in 3 months.

Oakleaf, I totally agree -- go into ANY procedure informed, and educated. Question everything, and double-check everything. You are your own best source.

[Cataboo]

The rate of women who survive breast cancer is going up - and the reason for that is early screening and awareness. There's some slightly better drugs, but mostly it's because breast cancer is being caught early enough that surgeons can remove them...

That's the same reason that cervical cancer deaths are down - continuous screening allows pre-neoplastic lesions to be caught. Do you know the death rates from cervical cancer in the third world? And breast cancer?

The rates of death from lung cancer has not really changed, because there's no better drugs, and at the point that most people find out that they have lung cancer, they have about six months to live treatment or not. Actually, there's been a pretty interesting shift in the type of lung cancer that's becoming more and more prevalent in females.

So anyways. Yes, I'm sure people are profiting from continual screening. And lots of people are surviving longer because of it. And it's a fact that more women are surviving breast cancer for longer periods - and the earlier your breast cancer is caught, the more likely it is to be curable.

As for whether or not the prevention industry has a vested interest in preventing a cure - that's nonsense. The prevention industry is the medical industry - and they'll profit way more off target designer drugs and cures than they do off prevention. That and I work in the cancer research field and it's not occured to any of us to just stop working on certain cancers because prevention'll fix it all. Making everyone stop smoking will mostly eradicate lung cancer, yet people are still working on lung cancer treatments.

As for the 1 in 8 applying over a lifetime - genetic mutations and damage accumulate in your body over time. As you get older, your immune system gets weaker.... You're far more likely to have cancers as you get older.

As for breast cancers mostly being slow growing - another thing I don't agree with.

So anyways. I wouldn't recommend forgoing mammograms and pap smears. Every other year might be more suitable for some age groups.

However, if you have health insurance and it's mostly covered - I really don't see what's the problem with getting them. Just like getting your teeth cleaned yearly. Yes, they're uncomfortable, yeah, they take an hour or two... HOwever, most of us take care of our bikes and cars better than we take care of our bodies.

[beccaB]

My Mom had a lump. She was afraid, which is understandable. She did not go find out what it was until you could see the way it was deforming her breast. She fought that cancer for 4 years until she succumbed at the age of 51. I am now the same age as she was when first diagnosed. If I can make it through this year with a clean mammogram I'll consider that a major stepping stone.
I was not ready to lose my mom when I was 26.
Ladies, please go have your mammograms.

[Blueberry]

However, if you have health insurance and it's mostly covered - I really don't see what's the problem with getting them. Just like getting your teeth cleaned yearly. Yes, they're uncomfortable, yeah, they take an hour or two... HOwever, most of us take care of our bikes and cars better than we take care of our bodies.

Radiation exposure is something some are concerned about. So, not exactly like getting teeth cleaned. I'm not there yet. I'll probably have a heart to heart with my doc. And I'll have them - yearly? I don't know. I have a family history, but it's clear the cause was HRT, not genetics.

Last time I had a Pap, she volunteered that they could to an HPV test at my next annual exam. If that's clear, no pap for 3 years. Still have to get an annual exam, but no pap. I appreciate that she made me aware of what the clinical guidelines are. Everyone should be so lucky as to have a doc who is open with her about such things.

CA

[Cataboo]

Radiation exposure is something some are concerned about. So, not exactly like getting teeth cleaned. I'm not there yet. I'll probably have a heart to heart with my doc. And I'll have them - yearly? I don't know. I have a family history, but it's clear the cause was HRT, not genetics.

Last time I had a Pap, she volunteered that they could to an HPV test at my next annual exam. If that's clear, no pap for 3 years. Still have to get an annual exam, but no pap. I appreciate that she made me aware of what the clinical guidelines are. Everyone should be so lucky as to have a doc who is open with her about such things.

CA


Does your dentist do x-rays annually?

[Aggie_Ama]

It is a personal choice, one you must weigh for yourself. Radiation is a real threat but then again so is breast cancer. You pick what is right for you but don't skip on discomfort alone or being nervous.

My original comment was more from personal bitterness that a member of my husband's family constantly tells anyone who will listen that she does not think anyone should have a colonoscopy and doesn't blame anyone for not having one. My father didn't want to do the prep until at 52 he starting passing blood. They found stage 3 cancer they could have caught at stage 1 if he had done the screen at 50 as recommended. Instead he now must get to a bathroom at the urge because they removed a larger portion of his colon. He had 6 months of chemo making the summer of 2006 horrible. He has a colonoscopy every year and I must have one 10 years earlier than I normal person. I try to respect my husband's family member but her reason is rooted in selfishness, she doesn't like the prep. No fact, she thought triggering diahrea in herself for a test was unfair and unjust. I cannot support this and never will no matter how much she thinks I should.

[Blueberry]

It is a personal choice, one you must weigh for yourself. Radiation is a real threat but then again so is breast cancer. You pick what is right for you but don't skip on discomfort alone or being nervous.


Very well said. I will likely follow my (very trusted) doc's recommendation. I certainly don't see myself not getting them. I was just pointing out that there are valid reasons to be concerned - either way. And you're right - it is a personal choice, but one that you should consider your family when making IMO.

And yes, I avoid dental x-rays as much as possible also. However, I've had some (as yet undetermined cause) pain and we've had to do the x-rays yearly of late. It's a risk, but there's also a symptom we're trying to resolve. But it's separate from a cleaning.

CA

[Tuckervill]

As for whether or not the prevention industry has a vested interest in preventing a cure - that's nonsense. The prevention industry is the medical industry - and they'll profit way more off target designer drugs and cures than they do off prevention. That and I work in the cancer research field and it's not occured to any of us to just stop working on certain cancers because prevention'll fix it all. Making everyone stop smoking will mostly eradicate lung cancer, yet people are still working on lung cancer treatments.

I wasn't talking about the prevention side of things. I was talking about the industry that has grown up around the fund-raising for breast cancer research.
Yogurt tops and pink mops.

Karen

[Pedal Wench]

I wasn't talking about the prevention side of things. I was talking about the industry that has grown up around the fund-raising for breast cancer research.
Yogurt tops and pink mops.

Karen

If it finds a cure to prevent the thousands of cases developed in the day that we've been having this discussion, and if that research prevents just one of the eight women having this conversation from having parts of their bodies cut away because we have no better options, then I'm buying every pink mop and yogurt top I can find.

[Cataboo]

Cancer is cancer - cures for breast cancer or basic research will translate into basic understanding and/or cures for other cancers.

As for all the funding that goes into breast cancer research, funding for basic research is really tough right now - so any money that's being raised towards a cure is great. And it means that if you're working on some aspect of prostate cancer or lung cancer, you'll make sure to do your results in parallel on a breast cancer line so that you can apply for that funding... Something that you would have made sure to do anyways just to make sure and validate that what you're seeing is not specific for prostate cancer only...

[Pax]

My Mom had a lump. She was afraid, which is understandable. She did not go find out what it was until you could see the way it was deforming her breast. She fought that cancer for 4 years until she succumbed at the age of 51. I am now the same age as she was when first diagnosed. If I can make it through this year with a clean mammogram I'll consider that a major stepping stone.
I was not ready to lose my mom when I was 26.
Ladies, please go have your mammograms.

((((beccaB)))) I'm so sorry you lost your mom, especially so young! :( I can't imagine my life without my mom.

[Crankin]

I find this discussion interesting. If someone was going to get sick from too many x rays, it would be me! I've had countless chest x rays because I had tons of upper respiratory infections, asthma, etc. in my 20's-40's. I had a cyst in my breast when I was 32. So I got my first mammo then, the next at 35, then at 40. After that, every year. In the last year I've had 3 CT scans. And, I do have dental x rays every year...
I have no family history of bc and quite frankly, I worry more about heart disease. I wish women would pay more attention to that, since the risk factors are mostly life style things that we all have control over... I'm not a doctor, but maybe those same life style things are also part of why so many of us get cancer? I'm not saying that riding a bike or eating right is going to stop all cancer, but, it just seems like a lot of people don't want to take responsibility for their bodies. OK, off of my soapbox because it's not exactly on topic.

And I know exactly what you mean by the bandwagon effect.

[OakLeaf]

If it finds a cure to prevent the thousands of cases developed in the day that we've been having this discussion, and if that research prevents just one of the eight women having this conversation from having parts of their bodies cut away because we have no better options, then I'm buying every pink mop and yogurt top I can find.

Buy away, but beware of "pinkwashing (http://www.thinkbeforeyoupink.org/)." There are many, many companies that sell products known or suspected to cause breast cancer, that once a year donate a couple of nickels to breast cancer research. Sometimes they're the very products that they paint pink each October.

If funding prevention seems as important as funding a cure, there's the Breast Cancer Fund (http://www.breastcancerfund.org/site/pp.asp?c=kwKXLdPaE&b=43969).

Radiation is by no means the only problem I have with screening mammography, as I noted. But if you're comparing procedures, modern digital mammograms deliver about triple the dose of a dental X-ray or 70 times the dose of a DEXA screen, directly to glandular tissue. Dental X-rays do have the potential to irradiate the brain, thyroid and parathyroid, but the beam isn't delivered directly to those organs. Each type of view exposes the patient to a different amount of radiation, depending among other things on the density and the thickness of the tissue being studied, and each type of tissue has a different level of sensitivity to radiation.


(((((((beccaB))))))) So sorry about your mom.

[Cataboo]

If any of you guys want, I can do a literature search and get some of the actual scientific articles on mammography screening and or risk factors. I'm not saying that the HON certified websites aren't great or whatever, because I haven't checked them out - but I always go directly to the source of information as opposed to letting someone collate or interpret it for me because I don't know their agenda or background. It's usually pretty laughable when you see the articles that science writers or reporters make reporting science, and then go read the original articles...

Or you guys can go to pubmed.com, do your searches and if you can't access any of the articles, I can probably download them through my work access.

Here's an excerpt written by Japanese doctors comparing the survival rates & screen between Japan & Europe/US:

Breast Cancer
© The Japanese Breast Cancer Society 2008
10.1007/s12282-008-0077-5
Current status of breast cancer screening in the world

Tadaoki Morimoto, Taeko Nagao, Kenji Okazaki, Misako Kira, Yasushi Nakagawa and Akira Tangoku

Introduction

In Europe and the United States, the mortality associated with breast cancer has decreased (by 20–30%) during a nearly 20-year period, dating from the late 1980s [1]. There are various reasons for this decrease, including an increase in detection of early-stage breast cancers due to increased use of mammographic screening and the establishment of standardized systemic treatments based on evidence-based medicine (EBM) [2, 3]. According to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER), breast cancer morbidity in the United States has been decreasing since mid-2002. This seems to be related to the first report of the Women’s Health Initiative and the ensuing drop in use of hormone-replacement therapy among postmenopausal women in the United States [4, 5]. However, in Japan, the breast cancer morbidity is increasing; and, in contrast to the overseas situation, the mortality also continues to increase due to a low detection rate for early-stage disease as a result of slow adoption of mammographic screening as well as other reasons [6]. We describe the history of mammographic screening in Europe and the United States and also breast cancer screening in Japan, while also presenting an overview of the current and future statuses of breast cancer screening both overseas and in Japan.
Results of breast cancer screening
Mammographic screening in Europe and the United States
Randomized controlled clinical trials (RCTs) of mammographic screening have been carried out for some years in Europe and the United States (Fig. 1). There have been various reports of assessment of their efficacy on the basis of the relative risk of death resulting from breast cancer, determined by metaanalysis of the results of those RCTs [7–9]. The US Preventive Services Task Force (USPSTF) reports that the relative risk of such death during a 14-year observation period was 0.84 for all ages, 0.78 for women aged 50 years or older, and 0.85 for those aged 40–49 years (each of these values showed a statistically significant difference). In other words, the breast cancer mortality was reduced by 16, 22, and 15%, respectively, in each of the age brackets in the screening group when compared with the unscreened group (Fig. 2). The conclusions of the USPSTF were as follows: “Based on fair evidence, screening mammography in women aged 40–70 years decreases breast cancer mortality. The benefit is higher for older women, in part because their breast cancer risk is higher” [10, 11]. Many countries in Europe and the United States are carrying out mammographic screening as a national policy, and the screening rate for breast cancer is high (70–80%). This approach has clearly been demonstrated to achieve a statistically significant decrease in breast cancer deaths due to increased detection of early-stage disease.

[OakLeaf]

That's the benefit. I didn't mean to suggest there was no benefit.

Now, what about the harms? For every identified cancer, how many healthy breasts were biopsied? For every cancer and especially for every "pre-cancerous" lesion that was treated, how many of them would have had any effect on the duration or quality of the woman's life if left untreated? What percentage of cancer treatments serve only to extend a woman's suffering? What is the quality of a woman's life after cancer treatment damages her heart and lungs? Regardless of mortality/survival, what is the recurrence rate?

Some of those answers are intangible. Some of them are still being researched. Others have never been studied - which is a great disservice. Because they are all important questions that should be considered before someone submits to screening. After screening identifies a so-called abnormality is not a good time to be making these decisions.

I'm going to make up some numbers here by way of illustration just so it's clear what terms mean. THIS IS NOT A REAL STUDY - there is no such study. I encourage everyone to do her own searches to find out what is and is not known on these questions. But to understand the statistics, one has to understand the language. Let's say 2,000 women are identified with DCIS. Half of them undergo lumpectomy with radiation, half of them receive no treatment. Of the treatment group, 80 eventually develop fatal breast cancer. Of the non-treatment group, 160 eventually develop fatal breast cancer. One way of looking at that is to say that treatment reduced mortality by 50%. Another way of looking at it is that for every 100 women who are treated, only eight are helped, and 92 are disfigured and irradiated unnecessarily.

Make your own decisions. Absolutely. And don't give my opinion any more credence than you would anyone ranting on the Internet - please don't. But please do become fully informed before making any decision about your health.

[uforgot]

I was 32 when my mom died of breast cancer. My brother, my dad and I took care of her during those final weeks. She was allowed to stay home through hospice, which was a godsend. Watch someone you love die of this disease and then let's see how you feel about the "risks" associated with mammograms. I've had yearly mammograms since I was 31 and I'm now 54.

[Cataboo]

I looked into this earlier but didn't have a chance to finish typing up a post, 'cause I decided to work at work instead :)

The standards for elderly woman are - if doctors expect that she still has a good 5 year survival rate, then they recommend that screening mammograms should be done. I'm assuming that they're basing that upon finding that if you have more than 5 years of life left, the benefits of mammography far outweigh the risks.

Risks of radiation damage by mammography - greater when you're younger, but after age 40, the risk is thought to be equivalent to smoking 3 cigarettes. The worst case scenarios that have been worked out estimate the potential for mammography radiation induced cancers to be 3 cases in 1 million women.

As for the pain of biopsy - I don't see how that's a risk of mammography. You get a big needle stuck in and something taken out. Yes, you have that happen and I guess there's a possiblity that malignant transformation or metastases is not going to occur for a while and there's not currently a good weigh of predicting that (however, from a biopsy or tumor sample it's usually fairly easy to see how disorganized the structure of the tissue is and how far along it is along the path.... And when you have metastatic tumors that can dump something like a million cells into the blood stream at a time... I'm thinking avoiding anything leading up to metastases is to be avoided)... However, pre-malignant lesions are usually just removed surgically and are not treated with radiation & chemotherapy - so now potential damage to the heart or lungs. You can also look at what genes are upregulated by the lesion - and there are several that have been associated with high risk of malignancy or death... That technology is still evolving...

However, I'm not sure if I have a pre-malignant lesion, I want to leave it in me just because the gene profile of it shows that it's highly possibly it will be stable for X number of years and risk it.

Anyways - I would love if everyone who reads something on the internet decides to research it themselves and takes it with a grain of salt. However, the number of people that think Obama is muslim has convinced me that is not so, and I know a lot of people hate mammograms and are looking for excuses to not bother and I'd hate for this forum thread to be their excuse.

[OakLeaf]

Okay, I'm venting now, and I know it. Let that by itself demonstrate the psychological trauma of a biopsy, and the complete absence of any provision in the oncology system to deal with that trauma. Of course it's enormously less than what someone with a cancer diagnosis suffers - of course it is. That doesn't mean that it's nothing (any more than a sprained ankle should be ignored just because it's not a leg amputation).

The idea that it's good to put lots and lots of people through repeated trauma, for the ultimate benefit of only a handful, goes straight to the psychology of loss aversion that I mentioned. Yes, the Brafman book is a popular, layperson's summary, but it appears to be well documented. No, I didn't review the psychological literature the way I read the medical literature, this was just a book my parents happened to send me at a coincidentally opportune time.

You're right, the biopsy pain was only significant for about two weeks. I could ride a bicycle on smooth flat roads after two days, run after a week, do aerobics after ten days. It was considerably more painful than the doctors would have one believe, but it wasn't intolerable. The back pain from being immobilized in spine extension was gone in a day or so.

The post-traumatic nightmares were gone after about three weeks.

The pucker in my breast where the main incision went is continuing to break up, and I'm hoping that by the end of a year it won't be so disfigured. The loss of volume in that breast, of course, is permanent. It's only maybe 5-10% of the pre-biopsy volume - obviously not even close to as disfiguring as a lumpectomy, but it is quite noticeable. I am hoping that the remaining breast tissue will rearrange itself so that there won't be such a conspicuous "hole" in one place.

Yes, I am too old to wear shelf-bra tops in public, but this is a s*cky way to be forced to acknowledge that, because they used to be my favorite summer wear. The external scars, judging by my other scars (and there are plenty of them), I'm guessing are permanent. Is this "just cosmetic?" Sure, in a sense it is, but don't underestimate how important a woman's breasts are to her sense of herself as a sexual being. I did totally underestimate that until it happened to me.

And then there's the sensation (or lack thereof) during sex. Anytime DH touches that breast, it reminds both of us of the pain, trauma and horror we went through together this summer. Let me tell you, that is an enormous turnoff; but having him totally ignore that breast during sex is emotionally painful, too. We're trying to work through it, and I'm sure we will be there someday. Physically, maybe the scars will regain the thinness and elasticity of the surrounding skin, so that DH won't be able to feel them, and maybe they won't. Maybe the sensory nerves will regrow and maybe they won't. Based on other injuries I've had, it's too early to tell those things.

Considering that the changes I had were a marker of an increased risk in either breast - and also considering that the absence of invasive cancer on an excisional biopsy correlates strongly with whether all the radiographic lesions were removed on the stereotactic, which they were - I really couldn't see a point in doing further damage to that breast. I do understand now, totally, why women have prophylactic mastectomies, something I never understood before. That's not my choice, but it's one of two ways that women have of going on with our lives and not permanently turning control of our bodies over to the doctors. I've chosen the other path, which is harder in some ways and easier in others.

Through all this, no one said one word to me about prevention. Things like avoiding bpA and parabens, I learned on my own (ironically only shortly before the biopsy). Things I probably should have known, like the fact that the two glasses of wine I used to drink with dinner was considered "heavy drinking" by the medical establishment, I had to learn on my own too - even though alcohol consumption was on the medical history forms I completed for both oncologists, neither one said a word to me about it. Things like what forms of soy are beneficial, what forms are definitely dangerous and what forms' effects are unknown, I had to learn on my own, even though I specifically asked both oncologists about soy.

At the median age where I'm at risk of developing breast cancer, I'll be 63. There's an 80% chance that I won't develop it at all. I'm at the age where I've been able to have "adult" conversation with a number of elderly people in my extended family, and except my mother - who's a special case, she'd be able to find something to enjoy in Hell - every one of them has told me, in these identical words: "Don't get old." I'm at the age where it's time to consider taking that advice.

My strategy for the future is to keep control of my body. I intend to remain as healthy as I can for as long as I can, and then to die as quickly as I can. We would do no less for our pets, why not for ourselves? Having put three dogs to sleep in the past five years, I'm acutely aware of this. I have no desire to die any time soon. But I have even less desire to have pieces cut off of me year after year after year, or to be sick, traumatized and miserable for years.

I will die someday. I'm becoming angrier and angrier at doctors who would like me to ignore that inconvenient fact. I don't think it's a service to myself or to anyone who loves me to obsess about it or to choose to die slowly.

[Pedal Wench]

Oakleaf, it's amazing how differently we view things. I've had quite a few biopsies, and while I don't take them lightly, I view them as blessings, because each one is my finding something early enough to perhaps save my life.

The scars DO go away, and the breast tissue DOES refill the spaces. I've had 5 lumps removed,and the only scar that's visible is the last one that was just a year ago.

Attitude is everything. You viewed (and still view) yours as an incredibly traumatic event. I view mine as an empowering, taking charge of my health kind of thing, granting me peace of mind that I'm not allowing cancer to grow unchecked in my body.

Also, removing the lumps that were biopsied make it easier, after healing, for me to feel new lumps that might develop.

Attitude is everything, and again, I hate someone reading this put off getting a suspicious lump looked at and possibly removed because of one negative experience. Had your biopsy revealed different, more tragic results, that early diagnosis could have potentially saved your life. We like you here - we think that life is worth saving. No one likes doing things that are uncomfortable, but we do them. Most people think exercising is just too uncomfortable - that's their excuse not to. But we do it, because it's good for us.

Edited to add: I gotta say -- finding a lump and NOT doing anything, to me, is much more stressful. I would much rather have it biopsied than feel it in there, hoping and praying it's not cancer growing unchecked.

[Brandi]

I was 32 when my mom died of breast cancer. My brother, my dad and I took care of her during those final weeks. She was allowed to stay home through hospice, which was a godsend. Watch someone you love die of this disease and then let's see how you feel about the "risks" associated with mammograms. I've had yearly mammograms since I was 31 and I'm now 54.
I lost my sister in law at age 34 of breast Cancer. No history in her family,they said it was enviromental. I watched my brother and my 3 year nephew go through hell and back from her dying. I am with uforgot on this one. A close friend of mine's mom this past year had a emegency mastectomy both breast. and cancer didn't run in their family either. I guess now it does. I should point out her mamogram did not show the baseball size lump hiding behind her breast. I was when they were removing some of her lymph nodes that the surgeon saw it. She had leaking out of her one nipple which is why they were removing the lymph nodes. She had had cervical cancer some years back. Oh that's another pet peev of mine. Pap smears! My friends mom had had a hysterectomy and figured she didn't have to ever have another pap. And then she got the cancer. PLEASE get your yearly check ups!

[OakLeaf]

...I hate someone reading this put off getting a suspicious lump looked at and possibly removed because of one negative experience. ... finding a lump and NOT doing anything, to me, is much more stressful. I would much rather have it biopsied than feel it in there, hoping and praying it's not cancer growing unchecked.

Thanks for the reassurances PedalWench :o

I said it before, but I really do have to reiterate that I would not hesitate for a second to have another biopsy if I had a palpable lump and a sonogram was inconclusive. I wouldn't suggest that anyone else hesitate to do so, either.

My comments are related ONLY to mass screening of asymptomatic individuals, and to biopsy of non-palpable radiographic lesions, and my experience alone.