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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 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.
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.
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.
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!Quote:
Originally Posted by uforgot
Thanks for the reassurances PedalWench :oQuote:
Originally Posted by Pedal Wench
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.