I voted AND had my first mamogram!

[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." 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.

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!