I voted AND had my first mamogram!

[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.

[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.

[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.

[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

[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.

[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.

[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.