I voted AND had my first mamogram!

[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 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 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 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

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

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?