# More fuel for the mammography debate



## Cletus (Apr 27, 2012)

This argument has been going on at home for a while now. 

Science Won?t Settle The Mammogram Debate | FiveThirtyEight

Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial | The BMJ

My wife says she doesn't care - she believes that early screening and detection saves lives, and so it must be so. I understand how personal this choice is. What's your take, especially since it's not even clear in randomized control trials that mammography saves any lives at all?


----------



## brooklynAnn (Jun 29, 2015)

In my family we don't have a history of breast cancer but we have ovarian cancer. So, I do my mammogram every 2 years, with self exams on a monthly basis. For other women who have a history, it's better if they have it once a year. So, it depends on whether you want to do it once a year or prefer to wait. Or, if you feel something is off.

Women's health should depend on the individual woman and her history.
Not by a group of so call experts at the health dept.


----------



## Cletus (Apr 27, 2012)

brooklynAnn said:


> Women's health should depend on the individual woman and her history.
> Not by a group of so call experts at the health dept.


Fine, but one ought to be consulting the experts on what is actually in your best interests, no? 

The problem with breast cancer is that women have been trained to believe that early detection ALWAYS implies avoiding death. More and more evidence is leading to the conclusion that this is not the case, and that lots of women are receiving unnecessary and invasive care that won't save their lives.


----------



## Pluto2 (Aug 17, 2011)

Just had a mammogram last week, and like brooklynAnn mentioned, I'm doing it every two years. I also have no history of breast cancer in my family,but was diagnosed with melanoma last year. I spoke with my MD about this and opted for the every year regimen. 

I've also known several women who have battled breast cancer and their 5 year survival rates are depending more on the specific kind of cancer they had rather than anything else. But all found out pretty early, or at leas that's what they were told. So based on my strictly limited anecdotal evidence, early detection of some breast cancers can prolong life after treatment, while early detection of others, won't. So it comes down to cancer sucks.


----------



## brooklynAnn (Jun 29, 2015)

We should consider what will make a women feel more secure in her health. The experts are her medical team, they with her decide what is in her best interest. I have heard of the increase of double mastectomies and how unnecessary they may be. But until we know more and have a greater pool of information, woman should be allow to make up their own minds.

Just my thought.


----------



## norajane (Feb 7, 2012)

I just turned 48 and haven't had a mammography yet. I do self exams, and the one at the gyno's (physcial exam but not mammography). BC doesn't run in my family, and I am not the least bit interested in a test that isn't particularly effective but is painful and invasive (IMO) when the studies don't show that the test will actually do me much good. To put it into perspective, try squishing your balls in a vice trying to find testicular cancer when you can probably do a manual exam and notice if there is a problem.

My parents are 70 and have some complaints. I have been appalled at how quick docs are to prescribe medications for them when it isn't necessary and the meds have actually been shown to be entirely ineffective (statins for women). My mom also had the experience of getting an MRI for a stomach issue she had, someone misread the scans and sent her home, only for her to return to the ER later and for them to find the problem, which required surgery. There's a reason it's called "practicing" medicine. Docs are not infallible, nor are lab techs and those reading the labs/scans.


----------



## CatJayBird (Oct 5, 2015)

I'm all on board with "Early detection is key"...this applies to multiple aspects in life! I had my first mammogram last year at 39 for an issue I was having...I had my second one last month. Mine were pretty simple, quick and painless. A little bit of discomfort, yes, but certainly not painful. I think a lot women fear the unknown pain that the mammography machines will cause.


----------



## Blondilocks (Jul 4, 2013)

It's up to the woman. Personally, I'm getting a little tired of doctors acting as though they are so disappointed that you are not taking their advice when every time you turn around they are urging you to get a mammogram. They act like they're on a quota system.

My cardiologist even asked me if i had one that year and if not his office would be happy to schedule one for me. Told that toad that when he got around to having his penis squished flat as a pancake and irradiated to let me know and I would consider it.


----------



## Runs like Dog (Feb 25, 2011)

More money is spent on breast health than all other cancers combined. And but for a small percentage of women (in the West that is) it's entirely a cosmetic decision. That goes down bitter and hard with most people but it's true. It's vanity. Obamacare would be more efficient if they simply offered free double mastectomies and double reconstructive surgeries to all women on demand and reduce the funding for breast cancer 90% while reallocating it to things like lung cancer, brain cancer, pancreatic cancer and the like. But that of course will never happen.


----------



## dignityhonorpride (Jan 2, 2014)

Runs like Dog said:


> More money is spent on breast health than all other cancers combined. And but for a small percentage of women (in the West that is) it's entirely a cosmetic decision. That goes down bitter and hard with most people but it's true. It's vanity. Obamacare would be more efficient if they simply offered free double mastectomies and double reconstructive surgeries to all women on demand and reduce the funding for breast cancer 90% while reallocating it to things like lung cancer, brain cancer, pancreatic cancer and the like. But that of course will never happen.


That isn't true. The danger with breast cancer is that it will spread to other tissues, namely the lymphatic and circulatory systems. Removing the lump does not prevent this from occurring, and radiation is still necessary. Before a mastectomy, the cancer can still have spread. For that reason, it's not the preferred method of treatment. And because that method is usually not medically necessary / indicated, it's not covered by insurance (for many patients). You can read more here: http://www.foxnews.com/story/2007/1...ast-cancer-and-why-shouldnt-believe-them.html


----------



## Runs like Dog (Feb 25, 2011)

And yet mortality plateaued 20 years ago. A huge portion of the funding goes into making treatment more palatable.


----------



## SurpriseMyself (Nov 14, 2009)

CatJayBird said:


> I'm all on board with "Early detection is key"...this applies to multiple aspects in life! I had my first mammogram last year at 39 for an issue I was having...I had my second one last month. Mine were pretty simple, quick and painless. A little bit of discomfort, yes, but certainly not painful. I think a lot women fear the unknown pain that the mammography machines will cause.


My mammogram hurt like hell; it does for many women.
_Posted via Mobile Device_


----------



## Anon Pink (Jan 17, 2013)

Hate hate hate mammograms! Hate them hate them hate them! And yes they hurt!

I saw that news a while ago about the mortality rate not being very effected by mammograms. That they caused routine invasive procedures that were unnecessary when a more conservative approach would have been better.

But ask yourself this. You're walking around with cancer cells mutating healthy cells in your breast and the doctor wants to stop at lumpectomy. But you know of several people who have died from cancer and all you can think about it get this out of my body and kill it now! Are you going to stick with your conservative doctor or are you going to find a surgeon who will cut that sh!t out and make sure it never comes back!

It's real easy to advocate for conservative medical advice after the fact or when it's not your body. Not so easy when it's you.


----------



## happy as a clam (Jan 5, 2014)

SurpriseMyself said:


> My mammogram hurt like hell; it does for many women.
> _Posted via Mobile Device_


I'll second this. They hurt like hell!

And I always get called back to come in for a follow-up ultrasound because, like my mother and sisters, I have lumpy breasts. So not only does it hurt, it ends up costing me a small fortune.

But I keep going back every year... 
_Posted via Mobile Device_


----------



## SurpriseMyself (Nov 14, 2009)

happy as a clam said:


> I'll second this. They hurt like hell!
> 
> And I always get called back to come in for a follow-up ultrasound because, like my mother and sisters, I have lumpy breasts. So not only does it hurt, it ends up costing me a small fortune.
> 
> ...


I am in the exact same situation as was my mom (who stopped letting them cut into her after the second lump in a row turned out to be a benign cyst). 

I'm not going back until I have an alternative (thermal imaging, ultrasound, something). Have had to call my dr three times to get them to understand that I won't be having another mammogram - they have to provide me an alternative. After all, if there are choices that are just as accurate and hurt much less, why can't I do it?!?!


----------



## Pluto2 (Aug 17, 2011)

One of my sisters is a mammography tech. She's told me several times if they hurt, the tech does not know what they're doing. I've started having them at 40 and I can honestly say I've never been in pain. For those who have pain, I hope you try a different clinic and find a competent tech.

And BS is not entirely a cosmetic issue! Good lord, what an ignorant assumption. There are types that are not operable.


----------



## SurpriseMyself (Nov 14, 2009)

Pluto2 said:


> One of my sisters is a mammography tech. She's told me several times if they hurt, the tech does not know what they're doing. I've started having them at 40 and I can honestly say I've never been in pain. For those who have pain, I hope you try a different clinic and find a competent tech.
> 
> And BS is not entirely a cosmetic issue! Good lord, what an ignorant assumption. There are types that are not operable.


After the first hurt so bad, I also heard that it shouldn't hurt and it was due to the tech. So I called a different place for my follow up. As I was trying to schedule, I explained to the younger woman who I trying to schedule with that I was going to a different place since the first one hurt so bad. She said she hasn't had one, but that patients tell her often how much they hurt. Scratch place #2 off my list! 

That's when I decided I wasn't having a standard mammogram anymore.
_Posted via Mobile Device_


----------



## Ikaika (Apr 23, 2012)

Ok, not exactly the same, butt still cancer screening. Setup: I typically have a low resting heart rate along with low blood pressure.

I'm getting ready for my colonoscopy after pooping out water for the last few hours (those who have been through it know what I'm talking about). The nurses (one which was a former student) were going through their normal prep. The nurse anesthetist, NA, was concerned when she saw my work up; focusing on my resting heart rate (these drugs typically slow your heart rate down). She called the anesthesiologist assigned. He came down asked me questions and then saw him (out of ear shot) conferring with then NA. I swear they must have talked about giving me a children's dose. Even though the drug was designed to leave me groggy, I was less then groggy and pretty sure I felt that probe up my ass the entire time. 

So much for trying to take of myself, I get paid back with a pain in my butt, literally.


----------



## norajane (Feb 7, 2012)

SurpriseMyself said:


> I am in the exact same situation as was my mom (who stopped letting them cut into her after the second lump in a row turned out to be a benign cyst).
> 
> I'm not going back until I have an alternative (thermal imaging, ultrasound, something). Have had to call my dr three times to get them to understand that I won't be having another mammogram - they have to provide me an alternative. After all, if there are choices that are just as accurate and hurt much less, why can't I do it?!?!


You'd think with all this research showing that mammograms are hardly effective at preventing breast cancer deaths that they would be full steam ahead in researching alternate ways to screen. 

Why did a test that can CAUSE breast cancer (via x-ray radiation) become THE test they recommend to search FOR breast cancer???


----------



## Cletus (Apr 27, 2012)

norajane said:


> You'd think with all this research showing that mammograms are hardly effective at preventing breast cancer deaths that they would be full steam ahead in researching alternate ways to screen.
> 
> Why did a test that can CAUSE breast cancer (via x-ray radiation) become THE test they recommend to search FOR breast cancer???


They are, of course. Genetic testing is the current frontier of the science, where we match the solutions for a given cancer to the individual. This is more than anything fueling recent advances in cancer treatment. Some of it is even preventative. The BRCA gene is the one that causes women like Angelina Jolie to have preventative double mastectomies. 

But finding a small lump buried in the middle of a mass of soft tissue is just plain hard to do. You take a higher dose of radiation living in Denver for a year than you do getting a mammogram, so it's just the best available tool at present. 

It's just a sad generalization that the cancers that are likely to kill you are so aggressive that they're hard to detect early, and the ones that are easily detected are often the ones that won't kill you.


----------



## WandaJ (Aug 5, 2014)

I'm doing it every two years. The funny thing is they recommend to do it every year to women in high risk group, with family history of breast cancer, but most women who do get it, do not come from this group anyway.


----------



## Aroleid (Sep 20, 2015)

My mammograms were only painful when I was at "that time" in my cycle, had some cysts, or back in the days, where the tissue had to be spread mega-thin.

As for the rest of them, discomfort is a better term, and I have always been accepting that as a matter of fact. 

Whatever the evidence is these days, if they are available to me, I will get the test done. It does have a place in prevention, in addition to self-exams. Especially when you can follow changes in tissue over time. a PAP smear will also not always detect cervical cancer, because the cells picked up are random. A cancerous cell could grow right next door, and your PAP would return as normal. Luckily, cervical cancer is much less prevalent than breast cancer.


----------



## Ikaika (Apr 23, 2012)

Best way to figure out the medical vs any personal debate is to look at the statistics. 

http://seer.cancer.gov/statfacts/html/breast.html

Median age of breast cancer diagnosis regardless of stage, 61 and current five year survival post diagnosis is nearly 90% for most patients diagnosed early. However one needs to be careful of this last statistic in light of the staging of diagnosis. Among all cancers it still leads the list in terms of deaths. 

So are mammographies the answer to early diagnosis and increases in the survival rates? If we compare regions that have the same ratio of diagnosis ~125 per 100,000 but lack same diagnostic tools (mammography) it's hard to make that direct connection because these regions do not have the same actuary stats for longevity. However, using our own population as its own control over previous decades, early detection no doubt has played a huge role. Yet, a mammography has its limitations and cannot directly decipher dense non-cancerous breast tissue from cancerous tissue. There are experienced clinicians who have seen enough to provide guidance on this one way or the other. And let's not forget, this is still a low-level X-Ray exposure, which can have its own carcinogenic effects. 

In terms of cancer treatments, this has certainly been an area where most of the progress has been made. 

Don't mind me as a gear up for my spring semester, Cancer Biology course. 

In all, weighing the benefits v the risk and do no harm is always a conflict that each physician along with their patient need to discuss. They should decide what is the best screening timetable. This should be personal and anything we hear in the news can be noisy guidelines.


----------



## Anonymous07 (Aug 4, 2012)

Every decision a person makes is about RISK vs BENEFIT. This is especially true when looking into medical care. 

Breast cancer does not run in my family and my risk is fairly low, so with that I have decided to wait in regards to mammograms and will do them every few years. On the other hand, colon cancer does run in my family and I will have to start the lovely colonoscopies at an earlier age to make sure I can catch anything early. There is no one size fits all approach, which is one thing that bugs me about certain public health policies. Each individual is different and needs to be treated as such. 

When you look at public health policies and why we do things, it is all about risk vs benefit. The risk of certain diseases outweighs the risk of vaccines. The risk of breast cancer outweighs the risks of mammogram radiation. There are always risks with any type of medical treatment, but if the benefits outweigh the risk, then it is worth it. This has to be individualized though, as the risk for vaccines might be worse than the risk for different preventable diseases. It comes down to each person and what their specific risk vs benefit is.


----------



## Pluto2 (Aug 17, 2011)

Anonymous07 said:


> Every decision a person makes is about RISK vs BENEFIT. This is especially true when looking into medical care.
> 
> Breast cancer does not run in my family and my risk is fairly low, so with that I have decided to wait in regards to mammograms and will do them every few years. On the other hand, colon cancer does run in my family and I will have to start the lovely colonoscopies at an earlier age to make sure I can catch anything early. There is no one size fits all approach, which is one thing that bugs me about certain public health policies. Each individual is different and needs to be treated as such.
> 
> When you look at public health policies and why we do things, it is all about risk vs benefit. The risk of certain diseases outweighs the risk of vaccines. The risk of breast cancer outweighs the risks of mammogram radiation. There are always risks with any type of medical treatment, but if the benefits outweigh the risk, then it is worth it. This has to be individualized though, as the risk for vaccines might be worse than the risk for different preventable diseases. It comes down to each person and what their specific risk vs benefit is.


Excellent observation.


----------



## NextTimeAround (Dec 15, 2011)

Runs like Dog said:


> More money is spent on breast health than all other cancers combined. And but for a small percentage of women (in the West that is) it's entirely a cosmetic decision. That goes down bitter and hard with most people but it's true. It's vanity. Obamacare would be more efficient if they simply offered free double mastectomies and double reconstructive surgeries to all women on demand and reduce the funding for breast cancer 90% while reallocating it to things like lung cancer, brain cancer, pancreatic cancer and the like. But that of course will never happen.


I have to admit, I did feel a little bit guilty. Breasts are not vital organs such as lungs or heart and so on. As one nurse put it, so much funding goes into breast cancer research because so many famous women survive breast cancer and can therefore fund raise for the cause ..... unlike other types of cancer. 

Farrah Fawcett didn't even have a chance........

Too bad the fundraising can't just go into one pot for cancer research. It was also explained to me that cancer treatments are so varied. If you have secondary lung cancer due to breast cancer for example, you will not receive the same treatments as someone who has primary lung cancer.

I watched the nurses in the breast cancer chemo unit. The chemo treatments are so varied the nurses always had to do something different with each patient.

thank goodness they're well trained and take their job seriously. (I hate the dumbing down of healthcare)


----------

