Author Topic: Ladies - mammograms  (Read 5131 times)

NewPerspective

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Ladies - mammograms
« on: April 12, 2018, 06:36:58 AM »
I'm curious about your thoughts on mammograms.  I've been reading some conflicting information about when, how often, how helpful they really are.  I will probably continue to get them done but I do feel a little conflicted about it.  They cause me a huge amount of anxiety but that would be a small price to pay if I found out early on I had cancer and it was treatable.

I'm 41 and I just had my 4th mammo/ultrasound this week.  I have fibrocystic dense breast tissue (no other risk factors, no family history), so every time I have an exam the doctor feels a lump and off I go for testing. 


wenchsenior

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Re: Ladies - mammograms
« Reply #1 on: April 12, 2018, 08:20:14 AM »
No family history here either, one fibristic spot in one breast, but I know not to worry too much over that.   Most women in my family have never gotten mammograms unless they had lumps, but I have tended to be more proactive generally with my health than is typical for my clan.  I just turned 47 and have only had one mammogram, when I was 42, I think.  I had been planning on getting one every 3 or 4 years, but last year was an insane orgy (not the fun kind) of medical spending and appointments, and I just didn't want to add another one into the mix.  But now I realize I've gone a third of this year and not yet done my ob/gyn appointment, or made the mammogram appointment.  I will get on it.

oldladystache

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Re: Ladies - mammograms
« Reply #2 on: April 12, 2018, 08:25:32 AM »
Never had one, don't plan to start now.

Looking at the statistics makes me not want to chance getting into the cycle of more and more testing, following up on things, possible unneeded surgerys

If I think something's wrong I see my doctor. Otherwise I keep my distance.

netskyblue

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Re: Ladies - mammograms
« Reply #3 on: April 12, 2018, 08:25:39 AM »
I've only ever had one, in my early 30s, because I felt a lump (which turned out to be a cyst).  The mammogram wasn't painful for me, but the lump was pretty anxiety inducing, even though there's no history of breast cancer in my family. 

I guess I'll go on whatever schedule is medically recommended when I'm old enough that they recommend doing it.  It was no big deal, other than taking the time off work for a doctor's appointment.

SoftwareGoddess

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Re: Ladies - mammograms
« Reply #4 on: April 12, 2018, 09:42:50 AM »
My GP sent me for a mammogram when I turned 40. (And he would have sent me earlier for a baseline reading, but it had been a few years since I had gone in for a checkup.) I resisted, because I had no family history and studies seemed to indicate that mammograms didn't impact survival rates before age 50, but he insisted. Surprise, I turned out to have stage 2 cancer! That was lots of years ago, and I'm still here to tell about it. I personally think that doctor saved my life.
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Bracken_Joy

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Re: Ladies - mammograms
« Reply #5 on: April 12, 2018, 10:00:27 AM »
See, I'm torn. On the one hand, I'm a medical professional and as you say, the research coming out is very much calling into question the value of mammograms without risk factors to indicate them. On the other hand, we would not have caught my mother's very aggressive breast cancer without her scan. It's amazing how anecdote in your life can really eclipse aggregate data.
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caracarn

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Re: Ladies - mammograms
« Reply #6 on: April 12, 2018, 10:25:55 AM »
What do people think about that studies that show that screening (for anything, but certainly breast cancer) leads to a lot more unnecessary procedures than it finds actual issues?  That's been the conflicting information that my wife and I talked about the last few years.  We're both in that age range.  For me, I'm getting to that prostate screening age but almost everything I've seen recently says it is so slow growing and again much more likely to get false positive and go down a path of unnecessary procedures and testing than actually catching a case that would kill you before something else did.  When similar "is screening worth it?" studies started coming out comparing our various rates compared to other countries who are not as aggressive at screening it seemed that maybe the mammogram should be looked at similarly.  My wife is in her 40s and would normally have gone ahead with the earlier recommendations but with my attitude towards my screening she has adopted a similar viewpoint, but the cancer progression of breast cancer is faster than what I am talking about, so we've recently been debating if that means she should not do it unless she feels a reason to (lump or something), just delay until 50 and still not due it every year, or what?

NewPerspective

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Re: Ladies - mammograms
« Reply #7 on: April 12, 2018, 10:26:55 AM »
Thanks for everyone sharing their thoughts.  My biggest issue is that it causes me a HUGE amount of anxiety.  Not the actual procedure, but the results.  Because I have fibrocystic tissue I'm ALWAYS lumpy, tender, achey, etc.   The whole thing just makes me want to run far away and bury my head in the sand (I haven't as you can tell my having had 4 so far at the age of 41) but I need to find a way to get a grip on the anxiety.   It makes me not be able to function when I'm in the grips of it.

I've tried reading some stuff of Stocism but it didn't really stick.  Maybe I'll try again.

I saw a therapist for 9 months last year but it seem to really help (although I liked her a lot).

NewPerspective

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Re: Ladies - mammograms
« Reply #8 on: April 12, 2018, 10:28:53 AM »
What do people think about that studies that show that screening (for anything, but certainly breast cancer) leads to a lot more unnecessary procedures than it finds actual issues?  That's been the conflicting information that my wife and I talked about the last few years.  We're both in that age range.  For me, I'm getting to that prostate screening age but almost everything I've seen recently says it is so slow growing and again much more likely to get false positive and go down a path of unnecessary procedures and testing than actually catching a case that would kill you before something else did.  When similar "is screening worth it?" studies started coming out comparing our various rates compared to other countries who are not as aggressive at screening it seemed that maybe the mammogram should be looked at similarly.  My wife is in her 40s and would normally have gone ahead with the earlier recommendations but with my attitude towards my screening she has adopted a similar viewpoint, but the cancer progression of breast cancer is faster than what I am talking about, so we've recently been debating if that means she should not do it unless she feels a reason to (lump or something), just delay until 50 and still not due it every year, or what?

I struggle with this too!  From what I understand, "things" come and go in our bodies all the time.  But it feels risky to just not do the screenings. But yes, I've read lots of articles saying many women have been treated for cancers that would have likely not caused harm.

caracarn

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Re: Ladies - mammograms
« Reply #9 on: April 12, 2018, 11:04:13 AM »
What do people think about that studies that show that screening (for anything, but certainly breast cancer) leads to a lot more unnecessary procedures than it finds actual issues?  That's been the conflicting information that my wife and I talked about the last few years.  We're both in that age range.  For me, I'm getting to that prostate screening age but almost everything I've seen recently says it is so slow growing and again much more likely to get false positive and go down a path of unnecessary procedures and testing than actually catching a case that would kill you before something else did.  When similar "is screening worth it?" studies started coming out comparing our various rates compared to other countries who are not as aggressive at screening it seemed that maybe the mammogram should be looked at similarly.  My wife is in her 40s and would normally have gone ahead with the earlier recommendations but with my attitude towards my screening she has adopted a similar viewpoint, but the cancer progression of breast cancer is faster than what I am talking about, so we've recently been debating if that means she should not do it unless she feels a reason to (lump or something), just delay until 50 and still not due it every year, or what?
Exactly.  They talk about so many cases where they found a nearly undetectable growth and immediately jumped to mastectomy because the woman was so afraid of cancer that she wanted it gone.  No monitoring to see if it was even growing or what, and then they had complications or other issues from the procedure.  In my thought pattern if I would likely not do anything with a positive result other than wait and see, then I lean towards why bother than.  I get that might mean I could miss something and it might kill me, but more and more studies seem to show I;m more likely to react to something and at minimum lessen my quality of life because of something that might not have really mattered anyway.

I struggle with this too!  From what I understand, "things" come and go in our bodies all the time.  But it feels risky to just not do the screenings. But yes, I've read lots of articles saying many women have been treated for cancers that would have likely not caused harm.

Sibley

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Re: Ladies - mammograms
« Reply #10 on: April 12, 2018, 11:26:08 AM »
My mom had the genetic testing for the known genes, came up negative, then got asked to submit DNA samples to several researchers who were looking for other genes. That's how bad it is in my family. The way the geneticist put it was kinda frightening: the family has a gene, we can clearly see it in the family history, but it's not one we know about yet, so we can't turn around and test the current generation.

Mom also had breast cancer, stage 1 but the absolute worst type you can get in terms of treatability and incredibly fast growing, though since they caught it so early it was ok.

If you have absolutely zero risk factors, including lifestyle, I could see waiting longer to start, reducing frequency, etc. Discuss with your doctor. However, I clearly don't fall into that category.

I think some of the research that's ongoing is really going to start to nail down when it's ok, when it's bad, etc. Next step is going to be educating all the doctors, then actually getting people to chill when it's ok to just watch things.

Milizard

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Re: Ladies - mammograms
« Reply #11 on: April 12, 2018, 11:32:12 AM »
Ive only had 1, at 44 I think.  Zero risk factors. I don't intend to get many more. I'm more likely to do a sonogram for testing. I think I read somewhere that they're better than mammograms, plus no radiation. I try to limit xrays. It annoys me when dentists take seemingly unnecessary amounts.

Norrie

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Re: Ladies - mammograms
« Reply #12 on: April 12, 2018, 10:17:43 PM »
Thanks for everyone sharing their thoughts.  My biggest issue is that it causes me a HUGE amount of anxiety.  Not the actual procedure, but the results.  Because I have fibrocystic tissue I'm ALWAYS lumpy, tender, achey, etc.   The whole thing just makes me want to run far away and bury my head in the sand (I haven't as you can tell my having had 4 so far at the age of 41) but I need to find a way to get a grip on the anxiety.   It makes me not be able to function when I'm in the grips of it.

I've tried reading some stuff of Stocism but it didn't really stick.  Maybe I'll try again.

I saw a therapist for 9 months last year but it seem to really help (although I liked her a lot).

I struggle with this a great deal too. My mom has had breast cancer twice (plus another kind of cancer, and then my dad has had four kinds of cancer), and I am considered high risk. Iím 42 now and have had annual mammograms for about six years. For the past three years Iíve been on an every six month schedule with the breast surgeon with alternating mammograms and MRIs, plus ultrasound at every visit.
I have incredibly dense breasts with tons of fibroids, and have had multiple biopsies, starting at age 25.

Sometimes it all feels like too much. The wait for results is often rough, and I feel like Iíve just shaken off the angst and itís six months later and time to do it all over again. But I will continue to do it because my risk score is so high and my parents have had cancer seven times between them. Self-exams are very hard to do on dense boobs with fibroids, and I can never trust whether the new lump I found is benign or something to worry about.

If I was at a low risk level with less dense breasts, I would feel more comfortable with skipping the annual mammogram. I hate feeling like itís a matter of when, not if, Iíll end up with cancer.

TheWifeHalf

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Re: Ladies - mammograms
« Reply #13 on: April 13, 2018, 07:32:17 AM »
This is not breast related, but a good example of why testing is important, when there are no problems:

I was in a car accident 10 years ago, TheHusbandHalf was too, no injuries to him.

However a few months after, he had vague feelings in his abdomen, so the dr did an ultrasound(??MRI??)

The conclusion - his feelings were due to the stress of my injuries. But the test revealed a teeny tiny lump in his bladder. It was bladder cancer, not even to stage 1 yet!
He is at the point where every 5 years he gets his bladder checked, probably for life.
 
He's worked at a refinery for over 20 years, and they are finding a connection to bladder cancer and refinery work. 
So, because of his cancer, he will get (not sure of the name) a camera used to see the inside of his bladder.

He disagrees with me when I say the accident was actually a blessing!

We had a similar story with one of our dogs

wenchsenior

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Re: Ladies - mammograms
« Reply #14 on: April 13, 2018, 07:43:06 AM »
To test or not to test, even to screen when you are healthy, is SUCH a mixed bag, though.  Even my doctors have wildly varying positions.  I've struggled to convince doctors to test me for certain things even when I had specific symptoms, because as my endocrinologist keeps saying, "if we test, we'll likely find something.  but that something isn't necessarily anything we can or should treat and will just lead to more testing and more procedures".  He's on one extreme.  I've had other doctors that insist on tons of screening procedures annually.  And I've had experience with both ends: I wanted tests done to identify causes of certain symptoms, and doctors resist.  Eventually tests are done and my suspicion was correct.  I've also been 80% sure of finding certain results in other cases, and I was wrong and there was nothing to explain the symptoms.  On the other hand, I've known a couple people that caught cancer in regular screenings or because of some test being done for something unrelated.  On the third hand, I also know two people whose bowels were punctured during standard screening colonoscopy and who then had to have emergency surgical procedures to repair.

Ugh, it's hard to decide what to do.  Usually, I'm half assed about screening unless I'm having symptoms and then I want everything that can be done to be done, which I don't think is a great approach either.  It doesn't help that I have two 'suites' of medical problems already (endocrine and autoimmune) and those can both present with tons of symptoms, and it's hard to judge how important any given symptoms is.

jeninco

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Re: Ladies - mammograms
« Reply #15 on: April 13, 2018, 11:44:52 AM »
The last time I had to find a primary care doctor I looked high and low to find someone who can "do" statistics. Seriously -- I don't care much about bedside manner, age, gender, etc etc, just can we please have reasonable discussions about statistics. (I'm a mathematician, so it matters a lot to me.)

I got a colonoscopy when I turned 50. I'm on the 10-year plan with that.
I've spaced out mammograms (but I do try to do self-exams every month or so in the shower), with my doctor's more-or-less blessing (no risk factors).

Not sure what I'll do about the next round of screening tests -- probably read up as they are suggested, and decide what to do. This is tough, though -- so much depends on risk factors, family history, etc. etc.

ePalmtrees

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Re: Ladies - mammograms
« Reply #16 on: April 14, 2018, 12:41:39 PM »
There is a pro-mammogram poster at my ob/gyn that says that if you catch breast cancer early enough, it's almost always treatable.

However what I have read, and I don't have the source but considered it to be credible at the time, is that although mammograms cut the rates of death from breast cancer itself, they don't cut the rates of death of overall. Because the cancer spreads so early that even if you have breast cancer and they cure it, later on you find it spread to a different place and basically, overall, mammograms don't save lives they just change what you die from.

Not exactly cheerful. I guess I will do some more research but will probably get a mammogram anyway. I guess it's a fear-based decision.

madgeylou

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Re: Ladies - mammograms
« Reply #17 on: April 14, 2018, 12:55:44 PM »
My mom died of aggressive breast cancer at age 32, so I've been getting them for the last 18 years -- I'm 45 now. I usually go every 18 months or so.

I did get tested for the BRCA genes and I don't have them, and I have no other risk factors -- no one else in my family history has had it, I don't have dense breast tissue, I don't have trouble with fibroids or anything reproductive besides periods that average like a 5-6 on the 10-point-I-wish-I-were-dead scale.

So, last time I looked up the statistics, 1 out of 8 women are expected to be diagnosed in their lifetimes. Having one close relative who has it increases the risk to 1 out of 7. Having non-dense, fatty breast tissue reduced the risk to below average. So, I dunno, I will probably keep getting them, but not every single year unless something else changes in my rather robust health profile.

iwannaretire

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Re: Ladies - mammograms
« Reply #18 on: April 16, 2018, 08:53:44 PM »
I also have mixed feelings about mammograms, but overall, I think I'm in favor of them.  I recently had about 6 weeks of stress after a positive finding on a mammogram, which resulted in a core biopsy and then a surgical biopsy.  The nodule turned out to be benign, but I did have atypical ductal hyperplasia (non cancerous abnormal cell growth), which is an increased risk factor for breast cancer.  I had no family history or risk factors for breast cancer, so all of this was a bit of a surprise. 

On the one hand, part of me wonders whether the problem would have went away on its own, or at least never amounted to anything, and I went through all these procedures for nothing (which were quite expensive even with a $500 deductible policy and 10 percent co-pay). 

On the other hand, when it was unclear whether I had cancer, it was comforting to me that I had done my annual screening and the nodule was so small that it likely had not spread.  When you are facing a possible cancer diagnosis, you do a lot of second guessing of everything you've done in your life, so I'm glad that ignoring mammograms was not one of them.  Plus, the oncologist told me that it is much harder to cure breast cancer once you have found a lump than when it shows up small on a mammogram. 

Overall, I guess I prefer to know what's going on in my body.  Now that I have a slightly higher risk of breast cancer, I know I should do things to mitigate the risk and to make sure I stay on top of things.  I wouldn't know that if I didn't have the mammogram.

Abe

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Re: Ladies - mammograms
« Reply #19 on: April 17, 2018, 01:41:02 AM »
Not a lady, but have some professional experience with breast cancer to help you all out with:

Death rates from breast cancer have declined from ~30 per 100,000 women per year in 1990 to ~20 now. Almost all of this is attributed to better treatment for breast cancer. Mammograms do not reduce the death rate, primarily because they catch small tumors that probably would have been caught once it can be felt, and the treatments are effective enough that they salvage that delay to some extent. That is the most common scenario by far (90% of cases in the US for non-Jewish and no-African descent women). The tumors that aren't responsive to chemotherapy are extra bad because they often spread microscopically by the time the main tumor is identified by mammogram. Those are the cancers women die of, and earlier detection would have only cured a fraction of them. Not to get too much in the weeds, but that is also slowly changing.

The main reason I'd get mammograms if I were female, and recommend them to my family members, is that early-stage breast cancer (no spread outside of the breast) often does not need any chemotherapy, while later-stage cancer almost always does. Chemotherapy for breast cancer has a lot of side effects. So it isn't necessary a survival benefit, but less treatment is required if you can catch a tumor early.

The data supporting every year screening is weak, primarily to the above reason (something that shows up within a year probably is either rapidly spreading, or would be treatable in the same way once it's found a year later). That's why some organizations recommend every other year for average-risk women.

Other screening methods include MRI if the mammograms are routinely inaccurate due to dense tissue, or if you are high risk based on family or personal history. Even without a gene mutation, one may be in this category (one of my family members is in this group). Their downside is they pick up things that end up being something other than a tumor (about 20% with current technology and an experienced reader). Ultrasounds have been studied in comparison to both and are not as sensitive for screening (they miss a fair number of the small tumors for technical reasons). They are used if something is found on mammogram and MRI, and are accurate then at figuring out if that specific spot is a tumor or not. There are no other imaging methods for screening that have been properly studied and shown to be as accurate. From my patients' experience, the MRI seems less uncomfortable than the mammogram, but getting insurance to cover it for that reason is hard. They also tend to cause more worry since they find thigns that end up beign nothing.   

One last thing to keep in mind: breast cancer treatment has changed dramatically, even in the decade since I started training. It has become so complicated that a lot of physicians who don't treat it on a regular basis are not as familiar with the standard methods now.

Hope that helps!
« Last Edit: April 17, 2018, 02:00:23 AM by Abe »

Letj

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Re: Ladies - mammograms
« Reply #20 on: April 17, 2018, 07:34:54 AM »
I did not follow the standard recommendation for breast cancer screening, opting to do self examination instead. However, when I started HRT at 48, I decided to do it annually because of the small increase in risk.

Lyssa

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Re: Ladies - mammograms
« Reply #21 on: April 17, 2018, 11:58:10 AM »
Not a lady, but have some professional experience with breast cancer to help you all out with:

Death rates from breast cancer have declined from ~30 per 100,000 women per year in 1990 to ~20 now. Almost all of this is attributed to better treatment for breast cancer. Mammograms do not reduce the death rate, primarily because they catch small tumors that probably would have been caught once it can be felt, and the treatments are effective enough that they salvage that delay to some extent. That is the most common scenario by far (90% of cases in the US for non-Jewish and no-African descent women). The tumors that aren't responsive to chemotherapy are extra bad because they often spread microscopically by the time the main tumor is identified by mammogram. Those are the cancers women die of, and earlier detection would have only cured a fraction of them. Not to get too much in the weeds, but that is also slowly changing.

The main reason I'd get mammograms if I were female, and recommend them to my family members, is that early-stage breast cancer (no spread outside of the breast) often does not need any chemotherapy, while later-stage cancer almost always does. Chemotherapy for breast cancer has a lot of side effects. So it isn't necessary a survival benefit, but less treatment is required if you can catch a tumor early.

The data supporting every year screening is weak, primarily to the above reason (something that shows up within a year probably is either rapidly spreading, or would be treatable in the same way once it's found a year later). That's why some organizations recommend every other year for average-risk women.

Other screening methods include MRI if the mammograms are routinely inaccurate due to dense tissue, or if you are high risk based on family or personal history. Even without a gene mutation, one may be in this category (one of my family members is in this group). Their downside is they pick up things that end up being something other than a tumor (about 20% with current technology and an experienced reader). Ultrasounds have been studied in comparison to both and are not as sensitive for screening (they miss a fair number of the small tumors for technical reasons). They are used if something is found on mammogram and MRI, and are accurate then at figuring out if that specific spot is a tumor or not. There are no other imaging methods for screening that have been properly studied and shown to be as accurate. From my patients' experience, the MRI seems less uncomfortable than the mammogram, but getting insurance to cover it for that reason is hard. They also tend to cause more worry since they find thigns that end up beign nothing.   

One last thing to keep in mind: breast cancer treatment has changed dramatically, even in the decade since I started training. It has become so complicated that a lot of physicians who don't treat it on a regular basis are not as familiar with the standard methods now.

Hope that helps!

It helps lots, thanks much!

Do you have an opinion on sonograms as an alternative screening methods for younger women?

My gyn is offering that and I'm thinking about getting one (I'm mid thirty).

Pigeon

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Re: Ladies - mammograms
« Reply #22 on: April 17, 2018, 12:13:59 PM »
My GP sent me for a mammogram when I turned 40. (And he would have sent me earlier for a baseline reading, but it had been a few years since I had gone in for a checkup.) I resisted, because I had no family history and studies seemed to indicate that mammograms didn't impact survival rates before age 50, but he insisted. Surprise, I turned out to have stage 2 cancer! That was lots of years ago, and I'm still here to tell about it. I personally think that doctor saved my life.

This is pretty much my story as well.  It's been 12 years for me.

Abe

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Re: Ladies - mammograms
« Reply #23 on: April 17, 2018, 06:23:46 PM »

It helps lots, thanks much!

Do you have an opinion on sonograms as an alternative screening methods for younger women?

My gyn is offering that and I'm thinking about getting one (I'm mid thirty).

Ultrasound has been compared in addition to mammograms (not instead of) and it did detect slightly more cancers than mammogram alone, but detected a lot more things that weren't cancer. This resulted in 5 to 10 times more biopsies. As a result, ultrasound alone is not recommended since it is not accurate. It is better than no screening, as long as the risk of extra unnecessary biopsies is acknowledged. In your case, unless you have a family history of breast cancer in the mid 40s or earlier, you don't need any screening now.

NewPerspective

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Re: Ladies - mammograms
« Reply #24 on: April 18, 2018, 07:28:21 AM »

It helps lots, thanks much!

Do you have an opinion on sonograms as an alternative screening methods for younger women?

My gyn is offering that and I'm thinking about getting one (I'm mid thirty).

Ultrasound has been compared in addition to mammograms (not instead of) and it did detect slightly more cancers than mammogram alone, but detected a lot more things that weren't cancer. This resulted in 5 to 10 times more biopsies. As a result, ultrasound alone is not recommended since it is not accurate. It is better than no screening, as long as the risk of extra unnecessary biopsies is acknowledged. In your case, unless you have a family history of breast cancer in the mid 40s or earlier, you don't need any screening now.

This is my situation now.  I always have an ultrasound with the mammogram because of the density issue.  The last time something showed up on the ultrasound that the radiologist feels very confident is benign.  He recommends doing another ultrasound in six months but said I can have a biopsy now if I'm worried.  He also said exactly what Abe said, that ultrasounds show more things that are likely not cancer but they have to be noted.  (I'll probably do the biopsy because I am worried, although I have no high risk factors.  Once you know something is there it is hard to not worry about it).



Hula Hoop

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Re: Ladies - mammograms
« Reply #25 on: April 18, 2018, 01:11:01 PM »
I have a mammogram and ultrasound every year due to family history of breast cancer.  I started at age 40 and now I'm mid-40s.  My doctor recommended the ultrasound/sonogram because I have dense breast tissue.  I often wonder if this is really needed but due to a family history of breast cancer it seems better safe than sorry.

sui generis

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Re: Ladies - mammograms
« Reply #26 on: April 18, 2018, 01:51:11 PM »
I had your same level of anxiety doing the monthly breast self exams they (used to) recommend.  Because of the lumpiness I just *always* felt something and was stressed out before and after.  At my annual exam this year, when my doctor did the manual exam I mentioned how guilty I feel about not doing that and how anxious it makes me and she said they've actually concluded it doesn't significantly contribute to early ID, so I shouldn't feel guilty and don't need to try to do it if I am not already.  Yay.

I just turned 40 so was expecting my first mammogram to be recommended.  Instead I got a request to enroll in the Wisdom Breast Cancer Study (https://www.universityofcalifornia.edu/news/massive-study-launched-test-personalized-approach-breast-cancer-screening).  I was just assigned to my experimental group, and will be doing the annual office exams, so I guess I won't be going for mammograms.  Hopefully helping to create good data for the future though!
« Last Edit: April 18, 2018, 02:23:58 PM by sui generis »

Lyssa

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Re: Ladies - mammograms
« Reply #27 on: April 18, 2018, 02:12:59 PM »

It helps lots, thanks much!

Do you have an opinion on sonograms as an alternative screening methods for younger women?

My gyn is offering that and I'm thinking about getting one (I'm mid thirty).

Ultrasound has been compared in addition to mammograms (not instead of) and it did detect slightly more cancers than mammogram alone, but detected a lot more things that weren't cancer. This resulted in 5 to 10 times more biopsies. As a result, ultrasound alone is not recommended since it is not accurate. It is better than no screening, as long as the risk of extra unnecessary biopsies is acknowledged. In your case, unless you have a family history of breast cancer in the mid 40s or earlier, you don't need any screening now.

This is my situation now.  I always have an ultrasound with the mammogram because of the density issue.  The last time something showed up on the ultrasound that the radiologist feels very confident is benign.  He recommends doing another ultrasound in six months but said I can have a biopsy now if I'm worried.  He also said exactly what Abe said, that ultrasounds show more things that are likely not cancer but they have to be noted.  (I'll probably do the biopsy because I am worried, although I have no high risk factors.  Once you know something is there it is hard to not worry about it).

Thank you both! I have a single aunt who's had breast cancer at a fairly young age (slightly younger than 40). Grandmothers and mother have not had it and afaik no other female relatives. I think I won't do any screening then. 5 to 10 times more biopsies seems excessive.

NewPerspective

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Re: Ladies - mammograms
« Reply #28 on: April 18, 2018, 02:23:29 PM »

[/quote]

This is my situation now.  I always have an ultrasound with the mammogram because of the density issue.  The last time something showed up on the ultrasound that the radiologist feels very confident is benign.  He recommends doing another ultrasound in six months but said I can have a biopsy now if I'm worried.  He also said exactly what Abe said, that ultrasounds show more things that are likely not cancer but they have to be noted.  (I'll probably do the biopsy because I am worried, although I have no high risk factors.  Once you know something is there it is hard to not worry about it).
[/quote]

Thank you both! I have a single aunt who's had breast cancer at a fairly young age (slightly younger than 40). Grandmothers and mother have not had it and afaik no other female relatives. I think I won't do any screening then. 5 to 10 times more biopsies seems excessive.
[/quote]

I had my first at 37, then 38, then 39 (the reason for all of these is because a doctor would feel a lump and insist I go (even though I told them I had always had lumps)- which of course scared me to death every time. ).  I skipped 40 and just had one a few weeks ago at 41.  I have to say, I'll probably continue getting them even though it causes me an EXTREME amount of stress and anxiety. But I think I'm too scared not to get them regularly. 

Pigeon

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Re: Ladies - mammograms
« Reply #29 on: April 18, 2018, 02:30:32 PM »
For those declining mammograms, please keep in mind that the vast majority of women diagnosed with breast cancer have no family history of it.

caracarn

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Re: Ladies - mammograms
« Reply #30 on: April 18, 2018, 02:32:15 PM »
Once you know something is there it is hard to not worry about it.
This is exactly the point that those opposed to screening without reason indicate.  It leads to a lot of, likely unnecessary, activity.

NewPerspective

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Re: Ladies - mammograms
« Reply #31 on: April 18, 2018, 02:47:56 PM »
For those declining mammograms, please keep in mind that the vast majority of women diagnosed with breast cancer have no family history of it.

Exactly.  This is mostly what will likely keep me going yearly.

When I told the radiologist I skipped last year and was considering only getting them starting at age 45 he said he would not recommend that.  I'm feeling a little bit calmer about it all at the moment.  One thing that I think has helped, I've stopped googling. 

NewPerspective

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Re: Ladies - mammograms
« Reply #32 on: April 18, 2018, 02:56:42 PM »
Once you know something is there it is hard to not worry about it.
This is exactly the point that those opposed to screening without reason indicate.  It leads to a lot of, likely unnecessary, activity.

I know! It is such a difficult situation.  (Part of me wants to just go with the Dr's recommendation of just doing a follow up ultrasound in six months but I don't want this in the back of my mind for six months either). 

Spudd

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Re: Ladies - mammograms
« Reply #33 on: April 18, 2018, 04:18:12 PM »
There's no breast cancer in my family but I plan to follow the Canadian guidelines anyways when I get to that age. It seems like they are recommending later and fewer mammograms than the US, for some reason. As I'm Canadian I would have to push to get more mammograms than recommended and I have no plans to do that!

Recommendations (Mammography) For women aged 40Ė49 we recommend not routinely screening with mammography. For women aged 50Ė69 years we recommend routinely screening with mammography every 2 to 3 years. For women aged 70Ė74 we recommend routinely screening with mammography every 2 to 3 years.

Making Cents

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Re: Ladies - mammograms
« Reply #34 on: April 18, 2018, 04:42:25 PM »
I don't have a problem with mammograms, though I do think the expense, time, and stress of overtesting is a problem in U.S. healthcare in general. If we had listened to doctors 10 years ago, my DH would have had his prostate removed in his late 30s when we were childless and wanting children. He still has his prostate today with no significant change in his test results because we refused to freak out and demanded alternatives. He simply monitors with more frequent/thorough testing. That is now the course of treatment that would be recommended for men that age, but it wasn't then. Seems breast cancer screening is going through similar debates on what is best practice.

I DO have a problem with breast biopsies when over 80% of them in the U.S. are benign (i.e. unnecessary surgery) and WHO recommends a lower biopsy rate than the U.S. currently follows. I think American healthcare is way too aggressive with stuff like this. I have no issue with tests/procedures that are backed up by clear evidence, but WHO evidence suggests that U.S. biopsies do not have better outcomes than more frequent monitoring. When i have a doctor demanding I do something that is not backed by evidence, this is when I get frustrated.

My breast surgeon last year for a (totally unnecessary and extremely expensive) biopsy did not ask my permission before putting a titanium chip in my breast (I would have declined) and did not listen to me or value my wishes to discuss less aggressive testing/treatment.  If I do ever get referred for another biopsy, this experience will factor into my decisions. I certainly won't be returning to that guy.

Mariposa

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Re: Ladies - mammograms
« Reply #35 on: April 18, 2018, 09:19:48 PM »
Mammograms do not reduce the death rate ...
 ...
The main reason I'd get mammograms if I were female, and recommend them to my family members, is that early-stage breast cancer (no spread outside of the breast) often does not need any chemotherapy, while later-stage cancer almost always does. Chemotherapy for breast cancer has a lot of side effects. So it isn't necessary a survival benefit, but less treatment is required if you can catch a tumor early.

This is an important consideration, but as a medical provider myself without increased risk except for having my child at older than 30, I'm strongly considering completely forgoing screening mammograms. If I decide to get them, I would get them every 2 years from 50-74, which is what the USPSTF recommends and is more closely aligned with Canadian and European guidelines.

The relatively small risk of having to undergo chemotherapy for a more advanced cancer has to be weighed against the much greater risk of increased follow-up testing, invasive procedures (biopsies), overdiagnosis, and overtreatment that goes along with mammogram screening. A significant number of breast cancers detected by screening would never have become clinically relevant (i.e., the woman would never have symptoms from it and would have died from another cause). The problem is, it's impossible to tell which ones those are, and once cancer is found, it's unethical not to recommend treatment. And there are significant side effects and sequelae from surgery and radiation, which may not actually be needed in about 20-50% of cases found by screening.

Source: https://www.cancer.gov/types/breast/hp/breast-screening-pdq

I do plan to continue with Pap screening (every 5 years with HPV co-testing) and do colon cancer screening in the future. The benefits for those are much more clear-cut. Pap screening also has a high false positive rate, especially for younger women, and can lead to invasive procedures with adverse effects (cervical incompetence), but it has a clear benefit in reducing cervical cancer mortality.
« Last Edit: April 18, 2018, 09:39:21 PM by Mariposa »

Abe

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Re: Ladies - mammograms
« Reply #36 on: April 19, 2018, 12:49:49 AM »
Your points are well taken, and I think mammography every 2 years for ages 50-70 with normal risk is sufficient based on the current data. There is good data that mammography decreases cancer-related mortality.

The main findings regarding mortality and cancer risk for these ages were:
Reduction of breast-cancer mortality by 14-33%, increasing with age. There was no difference in overall death rates since breast cancer is (fortunately) very often curable.
Reduction of advanced breast cancer (metastatic or big tumors) by 48%.
Conversely, a lot of the cancers found on mammogram are probably so slow growing that they don't need to be treated, given age and other factors. This number is really hard to determine, but current estimates are about 10-20%.
The incidence of breast cancer is low, so these percentages translate to a few dozen individuals per 100,000 women getting a mammogram!

In the other ages (less than 50 or more than 70) there was no benefit in mammography for average-risk women.

So there's no one-size-fits-all answer. There is evidence of a benefit, but it's a small one. The physical risks of biopsies are extremely low, but fear of the procedures can be a major (and normal) reaction. Also, treatment has variable side effects, and can be tailored significantly if something is found. If these are the concerns that worry you, it's worth talking to someone you trust who's been through it. I think overall knowledge is power, but that's just my opinion and there are equally valid opinions that too much knowledge generates unnecessary anxiety. 

caracarn

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Re: Ladies - mammograms
« Reply #37 on: April 19, 2018, 09:24:50 AM »
@Mariposa thanks for your information.  I was unaware of this group (USPSTF) and looked into it from your information.  Looks like a solid science based group that tries to provided what appears to be unbiased recommendations.  This helped with a few other things my parents are looking at so it was great to have this new resource to learn from.  Thanks!

Mariposa

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Re: Ladies - mammograms
« Reply #38 on: April 19, 2018, 01:04:21 PM »
Breast cancer screening has become even more controversial since I was in medical school. There are a number of different ways to present the data. The most rigorous analysis of the available evidence is presented in the Cochrane Review (meta-analysis), which I just looked at again.

To summarize:
1.   The review found 7 decent-quality randomized controlled trials involving 600,000 women. The higher quality studies (adequate randomization, involving around 300,000 women from what I could tell) found that screening mammograms did not reduce breast cancer mortality. The lower quality studies (suboptimal randomization) found that screening reduced breast cancer mortality.
2.   The overall body of evidence from all 7 studies taken together show reduced breast cancer mortality (a problematic end-point, since overtreatment with some combination of surgery/chemo/radiation itself may cause excess mortality, and other considerations).
3.   The authorsí best estimate is that screening reduces breast cancer mortality after 13 years by around 15%, and overdiagnosis and overtreatment is at 30%.
4.   This translates to, for every 2000 women invited to screening over 10 years:
        a. 1 woman will avoid dying from breast cancer
        b. 10 healthy women will be treated unnecessarily with some combo of surgery/chemo/radiation
        c. 200 women will experience psychological distress from anxiety and uncertainty for years because of false positive findings.

Under implications for practice, the authors conclude, ďWe believe that the time has come to re-assess whether universal mammography screening should be recommended for any age group.Ē

Hereís the full analysis, with a laymanís summary towards the beginning:
http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD001877.pub5/full

Interestingly, the independent Swiss Medical Board in 2014 reviewed all the available evidence, including the Cochrane Review above, became troubled at their findings, and recommended that Switzerlandís national screening programs be abolished, causing widespread uproar:

http://www.nejm.org/doi/full/10.1056/NEJMp1401875

The Swiss authors conclude, ďIt is easy to promote mammography screening if the majority of women believe that it prevents or reduces the risk of getting breast cancer and saves many lives through early detection of aggressive tumors.4 We would be in favor of mammography screening if these beliefs were valid. Unfortunately, they are not, and we believe that women need to be told so.Ē

I offer screening mammograms in my practice because all the US society guidelines currently recommend it, but taking into account the available evidence, I donít really believe in it, I donít push it, and Iíll probably forgo it altogether myself. Medicine does many amazing things (vaccines, insulin, hep C cure, and yes, many cancer treatments), but Iím also aware of its limitations. I take care of myself, exercise, etc, but when my time is up, itís up. Life is brief and precious, and there are no guarantees.

NB: Iím not offering anyone medical advice over the internet here. Iím just presenting my personal perspective as a woman who has considered the evidence and the very real medical controversy.






Mariposa

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Re: Ladies - mammograms
« Reply #39 on: April 19, 2018, 08:07:06 PM »
4.   This translates to, for every 2000 women invited to screening over 10 years:
        a. 1 woman will avoid dying from breast cancer
        b. 10 healthy women will be treated unnecessarily with some combo of surgery/chemo/radiation
        c. 200 women will experience psychological distress from anxiety and uncertainty for years because of false positive findings.

It's important that the Cochrane Review breaks things down this way. It's fair to give maybe +/- 10% to the numbers, but to compare (a)15% risk reduction in breast cancer death to (b)30% rate of overdiagnosis is somewhat misleading, since (b) is a percentage of a much larger number (breast cancer diagnoses, ~200k a year in the US) than what (a) is a percentage of (breast cancer deaths, ~40k a year in the US).

So, in absolute terms, if you're a woman of average risk, and you decide to go down the screening path, you have about 10x chance of being unnecessarily treated for an indolent breast cancer compared to having your life saved by early detection.

Of course, if you choose screening, you've got to commit to follow-up testing and treatment. To flip the overdiagnosis number the other way, would you turn down an excellent treatment for a condition that has a 70% chance of killing you?

Letj

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Re: Ladies - mammograms
« Reply #40 on: April 20, 2018, 06:49:34 AM »
Mammograms do not reduce the death rate ...
 ...
The main reason I'd get mammograms if I were female, and recommend them to my family members, is that early-stage breast cancer (no spread outside of the breast) often does not need any chemotherapy, while later-stage cancer almost always does. Chemotherapy for breast cancer has a lot of side effects. So it isn't necessary a survival benefit, but less treatment is required if you can catch a tumor early.

What do you think about screening for women using HRT? Should they get annual screening?

This is an important consideration, but as a medical provider myself without increased risk except for having my child at older than 30, I'm strongly considering completely forgoing screening mammograms. If I decide to get them, I would get them every 2 years from 50-74, which is what the USPSTF recommends and is more closely aligned with Canadian and European guidelines.

The relatively small risk of having to undergo chemotherapy for a more advanced cancer has to be weighed against the much greater risk of increased follow-up testing, invasive procedures (biopsies), overdiagnosis, and overtreatment that goes along with mammogram screening. A significant number of breast cancers detected by screening would never have become clinically relevant (i.e., the woman would never have symptoms from it and would have died from another cause). The problem is, it's impossible to tell which ones those are, and once cancer is found, it's unethical not to recommend treatment. And there are significant side effects and sequelae from surgery and radiation, which may not actually be needed in about 20-50% of cases found by screening.

Source: https://www.cancer.gov/types/breast/hp/breast-screening-pdq

I do plan to continue with Pap screening (every 5 years with HPV co-testing) and do colon cancer screening in the future. The benefits for those are much more clear-cut. Pap screening also has a high false positive rate, especially for younger women, and can lead to invasive procedures with adverse effects (cervical incompetence), but it has a clear benefit in reducing cervical cancer mortality.

sui generis

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Re: Ladies - mammograms
« Reply #41 on: April 26, 2018, 04:22:15 PM »
Crap, I was just on this thread bragging about not having to get mammograms because I enrolled in a breast cancer study and got assigned to the non-mammogram group (or whatever) but just got a message from them that, as part of the study and to properly assess my risk annually, they still need one baseline mammogram.  So I have to set one up.  My doctor, in making the referral I need, told me this:

"Please be aware that with starting screening at a young age (40 rather than 50) there is a higher rate of false positives- about half of women who get screened through their 40s will have a call back for more imaging or a biopsy- the majority of the time this will turn out fine. So if you do have an indeterminate result or they suggest more follow up, try to rest assured this is mostly due to your breasts being dense."

Now I have anxiety!  I really appreciate her warning, which I'm sure will be super helpful when they do ask me to do further imaging or a biopsy (please no!), but I am sort of regretting signing up to participate in this study now. :(

NewPerspective

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Re: Ladies - mammograms
« Reply #42 on: April 26, 2018, 05:03:19 PM »
Crap, I was just on this thread bragging about not having to get mammograms because I enrolled in a breast cancer study and got assigned to the non-mammogram group (or whatever) but just got a message from them that, as part of the study and to properly assess my risk annually, they still need one baseline mammogram.  So I have to set one up.  My doctor, in making the referral I need, told me this:

"Please be aware that with starting screening at a young age (40 rather than 50) there is a higher rate of false positives- about half of women who get screened through their 40s will have a call back for more imaging or a biopsy- the majority of the time this will turn out fine. So if you do have an indeterminate result or they suggest more follow up, try to rest assured this is mostly due to your breasts being dense."

Now I have anxiety!  I really appreciate her warning, which I'm sure will be super helpful when they do ask me to do further imaging or a biopsy (please no!), but I am sort of regretting signing up to participate in this study now. :(

Awwww, I TOTALLY feel your pain.  I actually have my (first) biopsy scheduled for Monday. Somehow though, I'm managing to control my anxiety.  However, I've had SEVERE anxiety attacks over this issue the last few years.  Sometimes to the point that I couldn't function normally in my day to day life (not eating, not sleeping, barely able to function at work).  I'm not sure exactly what has changed for me this time around.  I do think reading this thread was very helpful, particularly the posts by the medical professionals here.  Also, knowing that some women have been diagnosed at a young age and are obviously still doing well years later.    The last thing that I've been trying to internalize is that I can't control everything.  I exercise, eat healthy, low BMI, I've cut way back on alcohol consumption.  I can't help that I have dense breasts and if I end up with breast cancer, I'll deal with it as it comes.     With all that said, I've been told it will take 48 to 72 hours for the results.  I think that is going to be a very difficult couple of days.

Just know, it is very unlikely that there will be any issues for you!   And, be careful with google.  I found it comforting to take the online risk calculators.  They show a small risk of being diagnosed in the next 5 or 10 years (I'm sure your's would show that as well).  However, I was also reading messages on a breast cancer forum and realized that was really fueling my anxiety.  So my advice would be to not do that.  :-) 

It was actually after reading some stuff on the BC forum that I posted here.  I quickly realized these posts were more helpful for me at this time and I haven't been back there since.

Also, I'm a runner but I had slacked off some over the last year.  I've registered for a half marathon later this year and I think just getting out and running more makes me feel "healthier".  (I know everyone says exercise helps with anxiety, but I don't know, when it has me by the throat, absolutely nothing helps.  Just taking better care of myself seems to make me feel stronger though). 

NewPerspective

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Re: Ladies - mammograms
« Reply #43 on: April 26, 2018, 05:25:42 PM »
One other thought about anxiety.  I actually saw a counselor for about 9 months last year to try and get a grip on this anxiety.  (Mine is really centered around the idea of breast cancer).  I didn't think it really made much of a difference at the time (for me, as soon as I get the all clear, I stop worrying about it until the next year when I go in) but now that I'm dealing with the situation again, I do think the counseling helped. 

I'm able to recognize some classic "disordered" thinking.  Like immediately jumping to worse case scenario (catastrophic thinking), assuming I will die (very black and white thinking).  I also get weirdly superstitious, even replying to this post makes me feel a little uncomfortable (like oh next week I'm going to look back on this and think how stupid I was for saying I have a low risk).  But, now I'm able to realize, those are just my thoughts and they are not reality. We always imagine how things will be in certain scenarios.  The reality is almost always different than what we imagine anyway.

And finally, I live in a big city that is renowned for cancer treatment, I'm imagining you also have access to great medical care, I find some (not too much) comfort in that.  Although, living in this big city with a sprawling medical center, also means I sometimes feel absolutely surrounded by cancer.  TV ads, radio ads, billboards, emails, regular mail, etc.  I also think the easy access to testing and such makes doctors a little more prone to sending me off for testing.

My husband and I lived in Europe for a few years awhile back.  I sometimes wonder how it would be if I still lived there.  Mammograms or BC might not even be something I would think about (generally, screening starts at age 50 for women with no family history).

sui generis

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Re: Ladies - mammograms
« Reply #44 on: April 26, 2018, 05:33:23 PM »

Awwww, I TOTALLY feel your pain.  I actually have my (first) biopsy scheduled for Monday. Somehow though, I'm managing to control my anxiety.  However, I've had SEVERE anxiety attacks over this issue the last few years.  Sometimes to the point that I couldn't function normally in my day to day life (not eating, not sleeping, barely able to function at work).  I'm not sure exactly what has changed for me this time around.  I do think reading this thread was very helpful, particularly the posts by the medical professionals here.  Also, knowing that some women have been diagnosed at a young age and are obviously still doing well years later.    The last thing that I've been trying to internalize is that I can't control everything.  I exercise, eat healthy, low BMI, I've cut way back on alcohol consumption.  I can't help that I have dense breasts and if I end up with breast cancer, I'll deal with it as it comes.     With all that said, I've been told it will take 48 to 72 hours for the results.  I think that is going to be a very difficult couple of days.


Oh gosh, good luck on Monday and making it through the 48-72 hours after!

(and I know what you mean about superstitious thinking!)

iwannaretire

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Re: Ladies - mammograms
« Reply #45 on: April 26, 2018, 06:22:06 PM »
Having been through this anxiety earlier this, I can tell you that everyone always thinks worse case scenario, but the reality is, you just don't know, and there are lot of reasons for a callback.  The one thing that helped me deal with the anxiety was to think about all the things that were in my control (how I react to any news, how I can take care of myself, etc.) because the anxiety results from feeling out of control.  Best of luck no matter how it turns out.


One other thought about anxiety.  I actually saw a counselor for about 9 months last year to try and get a grip on this anxiety.  (Mine is really centered around the idea of breast cancer).  I didn't think it really made much of a difference at the time (for me, as soon as I get the all clear, I stop worrying about it until the next year when I go in) but now that I'm dealing with the situation again, I do think the counseling helped. 

I'm able to recognize some classic "disordered" thinking.  Like immediately jumping to worse case scenario (catastrophic thinking), assuming I will die (very black and white thinking).  I also get weirdly superstitious, even replying to this post makes me feel a little uncomfortable (like oh next week I'm going to look back on this and think how stupid I was for saying I have a low risk).  But, now I'm able to realize, those are just my thoughts and they are not reality. We always imagine how things will be in certain scenarios.  The reality is almost always different than what we imagine anyway.

And finally, I live in a big city that is renowned for cancer treatment, I'm imagining you also have access to great medical care, I find some (not too much) comfort in that.  Although, living in this big city with a sprawling medical center, also means I sometimes feel absolutely surrounded by cancer.  TV ads, radio ads, billboards, emails, regular mail, etc.  I also think the easy access to testing and such makes doctors a little more prone to sending me off for testing.

My husband and I lived in Europe for a few years awhile back.  I sometimes wonder how it would be if I still lived there.  Mammograms or BC might not even be something I would think about (generally, screening starts at age 50 for women with no family history).

Daisy

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Re: Ladies - mammograms
« Reply #46 on: April 26, 2018, 08:30:40 PM »
Ive only had 1, at 44 I think.  Zero risk factors. I don't intend to get many more. I'm more likely to do a sonogram for testing. I think I read somewhere that they're better than mammograms, plus no radiation. I try to limit xrays. It annoys me when dentists take seemingly unnecessary amounts.

I go to a holistic person for some chronic health issues. She doesn't like all of the radiation of mammograms and recommends a thermogram. Thermography uses infrared to detect the presence of cancers, no radiation. Actually my gynecologist reads thermography results and is OK with it, but she also keeps insisting on annual mammograms. Of course, insurance covers mammograms and not thermograms so it is out of pocket.

My holistic person's sister had breast cancer and had one breast removed. Once a breast is removed, you can't do a mammogram anyways (according to her) and then she got breast cancer on her other breast and then tried nutritional ways to get it under control. She changed her career at that point to be a thermogram specialist for this reason.

I finally had a mammogram last year to please my gynecologist (age 48) but not sure I need one EVERY year. Seems annoying to have to do when the original mammogram showed no findings. I'm OK with doing it every 3-4 years, but will have to hear her harp about it at every annual visit.

Also on an unrelated health issue I had a full body scan to search for tumors that they thought might have led to what I was suffering from at that time, and they found no tumors. So I am not too worried.

Ditto on annoying requests from my dentist for annual xrays. I've never had a cavity and have excellent oral health. I recently FIREd and am on one of the health sharing plans with no dental coverage. Now that I'd have to pay for xrays directly, I have even less of an interest in getting them at the dentist every year. I asked why they need to do it every year if I have excellent oral health and they have never found anything. They said it was for liability reasons mostly that they would push for it.

Plina

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Re: Ladies - mammograms
« Reply #47 on: April 29, 2018, 04:35:07 AM »
My grandmother had breastcancer twice so mammograms is not something I will skip when I get to the age. Here you have them between 40-74 years with an intervall of 18-24 months. I rather know as soon as possible.

Abe

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Re: Ladies - mammograms
« Reply #48 on: April 30, 2018, 08:45:23 PM »
Just to clarify - the controversy over screening mammograms usefulness is for women without other risk factors like family history or specific conditions. It can get complicated, but a good starting point is any parent or grandparent with breast cancer (men can get it too) - the risk for other family members sometimes is higher so all the assumptions about screening may be a bit different. In that case, itís a good idea to talk to your doctor to help predict your risk, and go from there on deciding.

BlueHouse

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Re: Ladies - mammograms
« Reply #49 on: May 01, 2018, 09:26:43 AM »
Thanks for everyone sharing their thoughts.  My biggest issue is that it causes me a HUGE amount of anxiety.  Not the actual procedure, but the results.  Because I have fibrocystic tissue I'm ALWAYS lumpy, tender, achey, etc.   The whole thing just makes me want to run far away and bury my head in the sand (I haven't as you can tell my having had 4 so far at the age of 41) but I need to find a way to get a grip on the anxiety.   It makes me not be able to function when I'm in the grips of it.

I've tried reading some stuff of Stocism but it didn't really stick.  Maybe I'll try again.

I saw a therapist for 9 months last year but it seem to really help (although I liked her a lot).

Can you ask for ultrasound instead of mammography?  I thought I had a lump once and when I expressed to the doctor that I didn't think the tech got the right spot in the mammogram, the doctor wouldn't let me leave until I felt comfortable that everything was checked and okay.  So he gave me an ultrasound on the spot.  Mammography has become so routine that you rarely get to speak to a real doctor during the process and the techs can't tell you anything.  This was a nice change from the routine and it really only came about because someone screwed up the initial mammogram and they had to call me back for a re-do. 
Sometimes nothing can be a real cool hand