<p>It sounds like I am in the minority on this. With the high rate of breast cancer in my family, I would much rather continue my annual mammograms, as unpleasant as they are. I would prefer that my insurance pay for it, but if not, I will probably see what it would cost if I have to pay. If you prefer not to have a mammogram, simply skip it. Nobody is going to force you to have one.</p>
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<p>^^^^If my husband’s colon cancer had been found early, he wouldn’t have had to have chemo, radiation, and major surgeries.</p>
<p>I am glad this is becoming more mainstream knowledge. </p>
<p>The information does not support routine mammograms in this demographic. I have argued with my care provider about this for years- insisting on a mammogram for me, and I have always said no. </p>
<p>The last appointment I walked in with printouts of the studies and said that I am going to follow best evidence. </p>
<p>He finally relented. </p>
<p>Two excellent resources for more information :</p>
<p>pink Ribbon Blues</p>
<p>And </p>
<p>Overdiagnosed</p>
<p>Excellent books handling the topic of over treatment and causing more harm than help in the name of “early detection”.</p>
<p>Of the women I know who’ve had breast cancer, all found a lump by self exam, not on mammography. </p>
<p>The study lumps (pardon the pun) all breast cancers together, when there are many different types. Presumably there were no differences in the distribution of these types between the two groups in the study, but the study does not make this clear.</p>
<p>Nerds–the comment on early detection finding cancers hard to treat was about breast cancer NOT colon cancer.</p>
<p>Nrdsb4–that statement about treatability was clearly, I think, directed at BC, not all screening results.</p>
<p>CF-- this is so true:</p>
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<p>And this why I very much doubt the ACA will be involved in stopping paying. Every death panel proclaimer would have a field day screaming “rationing”.</p>
<p>Yes, upon second reading, I can see that post referred to BC.</p>
<p>Due to my DH’s hell and my job (RN at endoscopy center), I’m very passionate about colonoscopies. Sorry!</p>
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<p>Actually, I think honest doctors have known that for a generation or more. Notwithstanding the development of mammograms and the huge PR efforts of the American Cancer Society and others, the age-adjusted mortality from breast cancer remained constant from the earliest public health statistics we had (mid-19th century) until tamoxifen went into widespread use about 15 years ago. There’s a case (and this study is part of it) that tamoxifen is the only treatment that actually works, short (perhaps) of prophylactic mastectomies for women with a high genetic predisposition to fatal breast cancer.</p>
<p>Also, I think the situation is a little worse than “the ones that can be treated don’t need to be found early, and early detection doesn’t help the ones that can’t be treated.” Early detection identifies many cancers, and many, many DCIS pre-cancers, that would go away by themselves without treatment, and effectively requires women to undergo expensive and difficult treatments, including mastectomies, to “cure” them. That is up to 1/3 of positive mammography results.</p>
<p>There is a sinister, or cynical, side to all of this. Early detection, and overtreatment, radically increases the number of women who see themselves as having breast cancer, or being at extreme risk for it, and exponentially increases the number of women who are “survivors” of breast cancer, thanks to their early detection, of course. That’s a huge, and enormously sympathetic, constituency for continuing mammography. It’s awfully hard to look a woman in the eyes and say that chances are her mastectomy was either completely unnecessary or not actually effective to prolong her life.</p>
<p>The fact of the matter is that the cell type of your cancer is what often determines the mortality rate. Some cancers metastasize very quickly, and are not chemo sensitive. You get one of those, it may not make any difference whether or not you caught it by the time the mammogram flags it or you feel it. It’s game over. You are likely to going to die of it, because it’s a chronic cancer and treating it is going to eventually kill you, and not treating it will too. It then becomes not so much whether it’s going to kill you or not, but how much longer you have to live before it does. You aren’t likely going to get rid of it, but you can keep it at bay or have it get you more quickly. The mortality statisitcs do not have a time element to it as to whether you lived 20 years or 5. </p>
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<p>Other relatives (including male ones) are aware of the risks, right? The common mutations associated with breast cancer (BRCA1 and BRCA2) are also associated with other types of cancer (ovarian for women, peritoneal and pancreatic for both women and men, prostate for men, and breast for men as well as women).</p>
<p><a href=“http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA”>http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA</a></p>
<p>I don’t see what is so terrible ‘physically’ about a mammongram, it’s not that painful. My gyno recommends I have one once a year and I am going to keep following his advice. What he doesn’t do anymore are pap smears every year, so he may change his recommendation on BC screening as well after this study. </p>
<p>I did have a cyst on my ovary detected when I had a CT Scan last month (for another reason which I finally got a diagnosis for after two months of running to doctors) and my Dr. wanted a follow up ultrasound sound done just to get a better picture of the cyst. I also asked for the blood tests which show a marker for ovarian cancer. Even though he told me it was likely a just a simple cyst - given it’s size - and that if it was his wife he was tell her not to worry about it - given my age and that I had other symptoms that may suggest ovarian caner - I still wanted the blood test. Blood work all came back fine and ultrasound showed it was indeed a simple cyst. </p>
<p>Since I was dealing with my then undiagnosed condition, it was important to me at the time to eliminate other possibilities. </p>
<p>JHS: Elsewhere I read that there was an <em>increase</em> in breast cancer mortality corresponding to the widespread use of estrogen for menopausal women, and the increase is just tailing off now. Is that incorrect? </p>
<p>I further read that we should expect a similar increase in prostate cancer ten years from now, because of the new fad of prescribing testosterone for the invented condition of low-T. Low-T appears to be a different way of saying, “Sir, you’re sixty, not twenty.”</p>
<p>I disagree that mammograms are useless. I do think they have been oversold, and I don’t think yearly was ever a good idea. But there is more to early detection than mortality. If a cancer is detected early, it cam mean less aggressive treatments, and for ER+ cancers, the possibility of avoiding chemotherapy for years. Early detection can mean less lymph node involvement, less aggressive surgery and the avoidance of Lymphedema. Overall, it can mean a better quality of life for the cancer patient.<br>
From my personal experience and the experience of many women whom I’ve talked with who are living with BC, finding cancer earlier, and treating it earlier, can prolong the “dormant” stage of the cancer and keep it from spreading to other organs for a very long time, even if it eventually does spread, which improves one’s quality of life.
Would you rather find your cancer early and take hormone therapy to keep it asleep for as long as possible or let it take off and discover it after it has gone to your bones, perhaps broken your vertebra, damaged your spinal cord or disintegrated your hips? If you find it early, you can keep these kinds of things from happening until the very late stages, if at all.
It’s about living well, not just living long.</p>
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<p>How about, radiation causes cancer?</p>
<p>^ I was referring to the squishing of boobs in the machine people so often complain about. </p>
<p>Emilybee–it’s not just the pain of the procedure; it’s the huge numbers of unnecessary treatments. And also, the amount of radiation --which in itself becomes a risk factor (with mammos, and much more so with CAT scans, which have been identified as a significant risk factor).</p>
<p><a href=“Opinion | We Are Giving Ourselves Cancer - The New York Times”>http://www.nytimes.com/2014/01/31/opinion/we-are-giving-ourselves-cancer.html</a></p>
<p>Thanks for the link. Informative. Hopefully, the one and only CT Scan I ever had last month won’t kill me! </p>
<p>I am still going to follow my gyno’s advice, others can choose differently if they see fit. </p>
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<p>Not that painful for you.</p>
<p>I have very dense breast tissue, so perhaps that affects my mammograms. I said in an earlier post that my most recent one wasn’t that bad, but the one prior to that was excruciatingly painful. It was so bad that I dreaded getting my most recent one so badly that I put it off for 2 years. I don’t know if it had to do with where I was hormonally that particular week, or if it was due to the particular technician, etc. I do know that it was horribly painful.</p>