Less Mammography in my future

[Pedal Wench]

I did have an aunt who started to have abit of breast cancer. But she died from totally different reasons at 82.

A bit of cancer? You either do or don't.

Unfortunately, family history is only a very small indicator of risk - I believe under 10% of women diagnosed have had a previous family history.

[indysteel]

A bit of cancer? You either do or don't.

Unfortunately, family history is only a very small indicator of risk - I believe under 10% of women diagnosed have had a previous family history.

Someone correct me if I'm wrong, but I think the genetic link is stronger if your family history has incidents of premenopausal BC, rather than post. That's why I decided it was best to start young.

Uforgot---I'm so sorry about your mom. (((((()))))))

[melissam]

What bothers me about this is that this is the best tool we have for screening breast cancer. This is a disease that affects a huge number of women, and we're told that early detection is the best way to prevent death from breast cancer. Yet, the screening tool is bad enough that they now think its risks outweigh its benefits until women are over 50. And then it's only useful every 3 years.

Oh, and all that self-checking every month stuff -- no, never mind, it's not useful either. And if I read correctly, they're thinking that breast exams performed by a doctor aren't that helpful either.

Ahem. Pardon my language here, but WTF?

Is someone working on a better screening tool? Until we get one, this is the best shot we have at preventing breast cancer, so I'm a little pissed about the experts recommending that we limit the use of this tool.

[ny biker]

What bothers me about this is that this is the best tool we have for screening breast cancer. This is a disease that affects a huge number of women, and we're told that early detection is the best way to prevent death from breast cancer. Yet, the screening tool is bad enough that they now think its risks outweigh its benefits until women are over 50. And then it's only useful every 3 years.

Oh, and all that self-checking every month stuff -- no, never mind, it's not useful either. And if I read correctly, they're thinking that breast exams performed by a doctor aren't that helpful either.

Ahem. Pardon my language here, but WTF?

Is someone working on a better screening tool? Until we get one, this is the best shot we have at preventing breast cancer, so I'm a little pissed about the experts recommending that we limit the use of this tool.

+1000

[beccaB]

I'm just going to keep on keepin' on. My Mom died of that disease three years older than I am now. If I get a false positive, further tests will prove one way or the other. I've has numerous call-backs. I'd rather that than the alternative.I have had one every year now since I was 40, 8 years ago. I made it past that certain age milestone where my Mom was first diagnosed. Every time I have a clean mammo I go buy myself a treat from Victoria's Secret!

[firenze11]

What bothers me about this is that this is the best tool we have for screening breast cancer. This is a disease that affects a huge number of women, and we're told that early detection is the best way to prevent death from breast cancer. Yet, the screening tool is bad enough that they now think its risks outweigh its benefits until women are over 50. And then it's only useful every 3 years.

Oh, and all that self-checking every month stuff -- no, never mind, it's not useful either. And if I read correctly, they're thinking that breast exams performed by a doctor aren't that helpful either.

Ahem. Pardon my language here, but WTF?

Is someone working on a better screening tool? Until we get one, this is the best shot we have at preventing breast cancer, so I'm a little pissed about the experts recommending that we limit the use of this tool.

I couldn't really put my finger on why this was bothering me so much, but you hit the nail on the head for me. I'm only 26 so maybe (hopefully) by the time I'm 40 there will be better means of detection and treatment. This just makes me feel confused and somewhat helpless. After watching my Mom's best friend battle breast cancer for over 10 years after late detection and seeing the pain her daughter faced and continues to face after she passed away this July, I can't help but feeling this is all too statistical.

[roadie gal]

MRIs and ultrasounds are both tests that are being studied. I'm not sure where either one stands at this time. Ultrasound is easy to get and does not irradiate you, but it's very operator dependent. It takes a very skilled technician to do it competently. MRI is extremely expensive and time consuming and a lot of people can't deal with the claustrophobia of the MRI machine. Also, if you have a pacemaker or other medical hardware you may not be able to get an MRI.

When I was in medical school in the last 70s to early 80s I was taught the incidence of breast cancer was one in 12 women. Now it's about one in 8. That's a HUGE increase. Some of it may be due to earlier detection of low level cancers that may have undergone spontaneous remission without treatment. But I believe those numbers do reflect a true increased incidence.

I've read some of the studies that look at mammograms as a screening tool, as well as self exam. None of the screening tools are great, but they're better than nothing. I'll keep getting my mammos until something better comes along.

[Running Mommy]

I just found out that my 63 yr old mom had a "bad" (her words) mamo in October. They are doing NOTHING at this point and just ordered another one in March. She's a bit freaked out as I am.
Last year I had my baseline mamo when I turned (ack) 40. They found lots of suspicious things and I was off for a battery of other tests, blood work and an ultrasound. Turned out ok. But I still feel like I need to keep an eye on it.
I had cervical cancer in 2001, so I am hyper sensitive to being diagnosed with another form of it. I just know of too many people who beat C the first time, but it got them the second time around.
I begged my mom to keep up w/the self exams and if she feels ANYTHING to make a beeline to the doc.
And now this comes out...
I don't really like it. I can see maybe doing it every other year, or even every couple. But to say that self exams are useless and to discourage them??
I would really like the "expert" that came up with that recommendation to explain their reasoning.

[fastdogs]

I'm thinking I'll stick to once a year still- except that probably after this, most insurance will not pay for it.
My sister never saw a doctor till she was 50. She felt a small lump and went in for her first mammogram. She found out she was stage 4 breast cancer- they removed both breasts and over 20 lymph nodes. It had already spread through most of her organs. She is still with us, but won't tell us how long she has left. The latest test was to see if it's spread to her brain, the only place it hasn't been found. Unless they can find the right chemo blend, she'll be on and off chemo and on heavy pain meds for however much longer she lives.
Before her, there was no history in my family.
vickie

[Pedal Wench]

I'm trying to figure out why this has made me so, so angry. I think I'm getting a grasp on it.

This task force has said that all the false positives just make women unnecessarily worried. It's all so degrading -- women are just so fragile that they can't make up their own minds and take charge of their bodies and health. Don't do a self-exam because you might not be able to handle the results or the stress while determining if it's a cancerous growth that might be silently killing you.

Even some of the opinions here - you might not feel that you want to know what's going on in your body, but for the government to tell women not to worry about it until they're 50, when so, so many women are dying because their cancer wasn't caught earlier is infuriating. Don't tell women to put their heads in the sand and their hands in their pockets. Feel your boobs, learn them, and know what your options are. It's my body, and I'll be damned if I'll let a government task force decide what's best for me.

In the interest of full disclosure, I"ve had numerous suspicious lumps, some discovered by self-exam, some on mammogram. I've had biopsies on most of them, and wear the scars proudly, because I know they're a symbol of me taking charge of my body and proactively fighting for my life.

[Pedal Wench]

Someone correct me if I'm wrong, but I think the genetic link is stronger if your family history has incidents of premenopausal BC, rather than post. That's why I decided it was best to start young.

Uforgot---I'm so sorry about your mom. (((((()))))))

From the American Cancer Society:
Family history of breast cancer

Breast cancer risk is higher among women whose close blood relatives have this disease.

Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2 first-degree relatives increases her risk about 5-fold.

Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Altogether, about 20% to 30% of women with breast cancer have a family member with this disease. This means that most (70% to 80%) women who get breast cancer do not have a family history of this disease.)

[ny biker]

Actually the recommendation regarding self exams was that having a doctor instruct the patient on how to do them was not helpful. It did not say that doing self exams was useless. I guess that means we are able to figure out how to do them on our own??

Anyway, as I said, due to my own risk factors I will continue getting annual mammograms unless my doctor advises otherwise. And I will be very surprised if he advises against them for my situation.

[shootingstar]

Each healthy woman makes an individual choice how often she would like to have a mammo...regardless of what her country's health care system advises.

I figure my chances on the bike on the road, I have greater chance of being doored, falling on the road (I have already --twice on ice.) or hit by a car (was hit as a pedestrian in front of a life insurance company)...are higher than breast cancer, at this time.

So I don't want to get a mammo yearly. Every 2 years ..continues to be the norm up in our jurisdiction...if a woman wants it that often.

As for being safe while cycling, that's why I would like my city to keep on building cycling infrastructure to make it safer. Meanwhile I continue to cycle my favourite routes that are quiet, etc.

Yes, it's all a risk. Meanwhile we all vigorously defend why we cycle so often on the road while other people think we are risking our lives/health.

[SLash]

I am high-risk for breast cancer and yet no family member has ever been diagnosed with breast cancer. I emailed my breast doc yesterday to see what he thought about the findings of the task force. I learned that prior to 1993; the National Cancer Institute endorsed mammography every 1-2 years in women age 40-49. Then in 1993 the NCI changed their policy and recommended mammograms at age 50. In 1996 the NCI changed its tune yet again and decided on “no policy”, then in 1997 they reinstated their original policy of mammograms ever 1-2 years for women in their 40s in accordance with the pre-1993 standards. Reportedly, none of these changes were based on new clinical trials either. Interesting huh…

In contrast, the American Cancer Society has maintained age 40 as the starting point for screening mammography from the beginning.

It is important to remember many women diagnosed with breast cancer have no known family history of breast cancer; and under the new guidelines if they are under the age of 50 they will not be targeted for a screening mammogram. According to the Task Force it is not statistically valid to screen women under age 50 because of the infrequency of cancer. I would say to the 1 woman per 1900 women in their 40’s that is found to have breast cancer, it is.

Dr. Otis Brawley, American Cancer Society's chief medical officer said it this way: the Task Force advice is based on its conclusion that screening 1300 women in their 50's to save one life is worth it, but that screening 1900 women in their 40's to save one life is not."

If you are a conspiracy theorist like myself you have to wonder what is behind this change. For one thing there is a lot of money spent each year on biopsies generated often by mammograms and often resulting in a negative finding. The woman looks at that as great news, her insurance company may look at it as proof of an unnecessary and more importantly to them, expensive test. So, to avoid the cost of the mammogram, plus the potential costs generated from further tests and procedures, you stop doing the test that identifies the problem in the first place.

One of the real dangers is that because of this change in mammogram guidelines that in time some insurance companies will either not cover mammograms for women under the age of 50, or will cover them in very limited situations and that will result in fewer women getting them.

The fact is, coverage of mammograms expanded when the guidelines for mammograms changed to recommend them annually for women 40 years of age and older it is not unreasonable to think they will change again with the new guidelines.

When insurance companies do not cover preventative tests, people are not nearly as apt to get them, and when people do not get the preventative tests diseases such as cancer are not caught as early and the survival rate goes down. That's the real shame in all this.

Getting off soapbox now...

[Tuckervill]

I heard on the radio today that every state except Utah has laws that require insurance companies to cover mammograms for women 40+.

Karen