Latest report on Breast Cancer and Mammograms I'm so angry I don't know what to do!

[Robyn66]

I was diagnosed with stage 2 breast cancer last year when I was 42 years old. I cannot emphasize one point enough. THIS WAS NOT CAUGHT EARLY, IT WAS CAUGHT IN TIME, I am talking about at the last opportunity before I was going to be really in trouble.

You see, I have no history in my family of breast cancer and I never wanted to get a mammogram in the first place, so I put it off. So I didn't get my baseline until the day the found the cancer. I had to have a radical mastectomy because as my oncologist put it the breast was "pretty full of cancer" and I had one lymph node involved so I needed chemotherapy.

I have a good chance of never having another problem again, but I would have had a BETTER chance if I had started getting mammograms at age 35 like my doctor wanted me to. I KNOW they would have caught the cancer before it was in a lymph node.

Now, some government panel is saying women don't NEED mammograms until they are 50. Two years ago I would have been PSYCHED about that. I would have been able to put that off for another 8 years. I am SICK when I think of how far the cancer would have advanced by that point if I had.

Insurance companies already don't want to pay for mammograms, and the fact is, breast cancer is being found in younger and younger women every day. But the sooner you are diagnosed the better chance you catch it before it has spread. When mammograms and biopsies start getting considered "unnecessary" or "over ordered" women are going to start DYING. They will be diagnosed at stage 3 or 4. It makes me wonder who made up this government panel and where the insurance company lobbyists fall into play.

This makes me so incredibly angry and I don't know what to do. Do I call my congressman? I wish I could talk to Keith Olberman because this is the type of thing I imagine he would be all over. I have been absolutely furious sick and sad about this since I heard last night and I don't know where to start fighting but the fighting has to start somewhere!! Our mothers sisters daughters and friends LIVES depend on it!!!!

[NV Whino]

1. This makes me angry also

But could you provide a link? Thanks.

[noiretextatique]

2. i feel the same way...diagnosed at 49

after two previous benign tumors were removed. i've been having mammograms since i was in my thirties because of fibroid tumors. i was stage 2 also, but no lymph involvement, so i had a lumpectomy and radiation. early detection, at any age, saves lives. i really don't think they want to piss off breast cancer survivors...we are survivors for a reason.

[LisaM]

3. "insurance companies don't want to pay for mammograms"....

I think that is the most telling point of your entire (great) post. The findings infuriate me, also. I even heard someone say, rather callously, I thought, that "oh, it might save one in a thousand lives". I think that's a lot!!

[hlthe2b]

4. The situation is very complicated... Truth is that we need better

screening tests and we need far more information on which cancers respond to early intervention and which types may involve cancerous cells that can and do revert to normal on their own. I share your frustration, as those of us in medicine and public health are in a quandry as to what to tell women. Truth is, though, that mammography can be extremely helpful and combined with ultrasound can detect early lesions. The problem is that it also picks up lots of false positives and suspect masses that may not require such aggressive intervention.

Just as with prostate cancer, where the value of PSA testing is now being reevaluated, the next few years are likely to bring lots of reexamination of mammography for breast cancer. Hopefully, it will also spur on development of better screening tests and protocols.

But, I share your concern and frustration--truly. Thank heavens for your early findings and response to treatment. Be well.

[Individualist]

11. Agree

It would be great if someone could come up with a screening procedure that would actually detect cancer.

[ohheckyeah]

17. It is complicated and studies in other

countries have come to the same conclusions about mammograms. There are other testing methods that are more accurate and less dangerous.

[Robyn66]

41. The fact is if you don't go for the test the cancer isn't found

Until a better way of looking for cancer is found all we have is a mammogram for a starting point. After the "troubling" mammogram I had, I was immediately sent for an ultrasound and then an MRI after which I had a biopsy. I'm sorry people have had false positives but I would not have regretted one test I had to take even if it turned out I didn't have cancer. Even if I was stuck with the titanium clip forever as long as I didn't have cancer.

I will tell you something else, while in chemo I met HUNDREDS of women coming and going and not a SINGLE ONE would have been willing to wait and see if the cancer that invaded their body would kill them or not. They wanted it out or killed. Members of the medical profession who can sit there and look at a cancer patient with a bemused expression and talk about irregular cells and the possibility that the cancer may not kill you have never looked down the barrel of the gun that is a cancer diagnosis.

You don't know what it is to wonder if you are going to see your children grow up or to grow old with your spouse. If you have spent your entire adult life working and have never spent enough time doing the important things like spending enough time with your loved ones because you have a mortgage to pay and food to put on the table and then you are SLAMMEd with a cancer diagnosis and the ONLY light at the end of the tunnel is that it was caught in time.

So any medical provider who can look a woman in the face who is 50 years old with stage 4 cancer who could have been diagnosed with stage 1 or 2 at age 40 deserves to be in a special place in hell.
Doctors need to use ANY TOOL THEY HAVE to detect cancer. If it isn't ideal then find something else but until then these women have a right to their lives and as far as I'm concerned one life lost is too many!

[hlthe2b]

47. Robyn66, I appreciate the way you feel...

I too have had a past mammography scare and while I was fortunate, I can certainly appreciate the feelings you describe. Most providers will be unlikely to change their screening recommendations at this time, without an alternative screening protocol shown to be more effective, I feel certain. The truth is, though, Robyn, is that the problem is not simply false positives, but false negatives. Mammography, for all its benefits, suffers greatly from subjectiveness and individual variation, which can ultimately prove normal, or not. That has been the problem with screening younger women-- a much greater frequency of "false negatives" because the breast tissue is so much more dense. Even screening during the last two weeks of the cycle can add to the likelihood of a false negative--to say nothing of operator and radiologist variability. Yet, it can still be a godsend in many cases, picking up tumors at a stage that self-exam would never detect.

Please don't draw conclusions that the health community is simply uncaring or willing to sacrifice for cost savings. That is not the case, at least in my experience. But, as I (and others) have pointed out, mammography is limited as a primary screening tool. If you scroll down this thread someone posted some promising alternative tests being studied both in the US and overseas that may eventually eliminate mammography as our primary tool for early screening. THAT is what we really need.

[Robyn66]

50. Good, the sooner we have more accurate tests the better

until then women should not be discouraged about taking care of themselves. Its a dangerous game to play. Hopefully these tests will be available before too many women in their 40's decide to skip mammograms until they are 50 and wake up one morning to find out they are dying. I guess its just a case of "there but for the grace of God, go I"

[Nikki Stone1]

54. .

.

[hlthe2b]

63. Did you forget to post your comment?

[sinkingfeeling]

5. What we need is something to replace mammograms. I underwent two biopsies in my

30's because the mammograms showed 'something'. Both turned out to be nothing at all and were written off as 'dense' breasts. These were not needle biopsies. I went in one day and had to stay the night in the hospital.

[kiranon]

30. Count your blessings. I had a biopsy and it came up cancer and I spent

a lot more time in hospitals than that but I am here to show for it. False positives no matter how inconvenient do not make the bottom fall out of your world.

[goclark]

59. Ms. goclark had two false positives

and I am grateful for having them and that my insurance paid for them.
I know how surprised I was that both had to be done because I didn't feel anything by self evaluation.

I feel like you do ~ it was not inconvenient, it was a blessing that I was able to have good medical care.

They need to do more studies before they come out with such a change as this ~ didn't the American Cancer Society totally disagre?

[Robyn66]

42. Congratulations on not having cancer

isn't that really what is important?

[Contrary1]

51. Lucky you...I had a mastectomy with reconstruction

and I got to stay a whole night in the hospital too.

[liberalhistorian]

6. I understand exactly where you're coming from and I agree.

I'm 44 and already I've had three friends who got breast cancer in their thirties. Cancer that would never have been discovered if they hadn't pushed their doctors for mammograms and insisted on it; they had no risk factors, so the docs didn't think they had to bother with it. Had they followed their doc's wishes and waited, they'd all be dead by now. Younger women under forty represent a larger and larger percentage of breast cancer victims and it's truly mind-boggling that that wouldn't be taken into consideration and that these "recommendations" would be made.

[NV Whino]

7. Found a link

http://abcnews.go.com/Health/OnCallPlusBreastCancerNews/mammogram-guidelines-spur-debate-early-detection/story?id=9099145


Here''s another thread on the topic.
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x4148888

[mike_c]

8. another vote for "complicated situation...."

Like many things medical, the recommendation is based on PROBABILITIES, not certainties. I'm not going to argue for or against that recommendation-- it's just not my field. But the issue is that for most people, most cancers are degenerative diseases, meaning that the longer we live, the greater our likelihood of developing them. Averaged across the entire population, the likelihood of developing breast cancer is significantly greater after 50 than before it, so it makes sense to concentrate the detection effort where the likelihood of disease is greatest. At the same time, there are costs and risks associated with detection-- the direct cost of obtaining mammograms, the indirect cost of lost time doing other things, the risk of radiation exposure that attends every imaging-- these costs and risks accumulate throughout life. It's the effort to balance the costs and benefits-- too early accumulation of cost and risk, verses early detection likelihood that increases significantly after 50-- that focuses on minimizing costs while maximizing benefits over the entire population.

If every woman got a mammogram every year after puberty, breast cancer severity could be significantly curtailed. On the other hand, every woman would accumulate costs and risk at unacceptable levels over the course of their entire lifetimes, and many women would develop cancer because of the increased radiation exposure. But since developing cancer is a probabilistic event, we can predict with certainty that SOME women WILL develop breast cancer at a young age, and older screening is bad for THOSE women.

You're apparently one of them. You're lucky you caught (edit-- "detected") your cancer when you did, especially with your history of avoiding mammaograms-- fair disclosure, I'm a male over 50 who has never had a colonoscopy, so I can totally relate. But beginning annual mammograms for all women at an early age because we KNOW that some will develop early cancers exposes the women who we equally well know won't develop early cancer to unacceptable risks and costs.

Life is full of uncertainties. The only way to know whether you're one of the people in the tails of probabilistic distributions is to act as though you are from the beginning, even though-- by definition-- you probably aren't (I mean "you" in the general sense-- YOU obviously ARE one of those people in the distribution's tail).

[Greyhound]

9. I think you've pointed out a major problem in this and many other issues.

Statistics are a wonderful tool (when used by people that understand them) but are only one tool and only useful in very general ways. Over the years we have become obsessed with them and make far too many important decisions based solely on them.

It's the old "Bill Gates walks into a room with a thousand homeless people and they all become multi-millionaires, statistically" thing.

[mike_c]

14. the real problem, I think, is that people want a simple recommendation...

...rather than taking the time to understand the real situation. Rather than recommending that women wait until they're after 50 to get annual mammograms, it would be far better to just release the results of analysis and let people make up their own minds-- at least in a perfect world. Show folks the curves for the age specific distributions of breast cancer detections and breast cancer fatalities juxtaposed with the curves for cost/risk accumulations when annual mammograms begin at, say, five year intervals beginning at age 25. That way people would see for themselves that the risk of developing breast cancer is relatively low for most younger women, but not for all, and they could decide for themselves whether the increased cost and risk that accumulates with earlier screening is worth it to them-- but for most women, until we have better ways to predict where an individual will fall on that curve, it's a crapshoot, plain and simple. It comes down to asking "How prudent do I want to be?"

[Robyn66]

43. You understand really well once you have had cancer

and you are only 42 that you are one of the people who would be fucking dead.

[Raschel]

68. I love you!!!!!

[Greyhound]

80. Going through it right now. n/t

[Generic Other]

55. one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years

"The task force concluded that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 59, and one death for every 377 women age 60 to 69."

http://www.nytimes.com/2009/11/17/health/17cancer.html


I am disturbed at the notion that one cancer is detected for every 19,040 exams given (10 per woman over 10 years) for women in their 40's. This means 19,039 exams exposed healthy women to dangerous radiation not to mention unnecessary biopsies of benign cysts and tumors when they really weren't at risk.

What seems fairly clear to me is that the medical community, the drug companies and health insurance industry have all profited handsomely at the expense of healthy women being irradiated unnecessarily. They also do a thriving business in hysterectomies. Cutting and mutilating women is a medical specialty in this country.

I don't trust them.

[Robyn66]

73. Then the task force is wrong

Maybe they should go to Dana Farber when I have my next check up and tell the 50 or so women in the infusion room who are under 50 that they are the acceptable losses. They should have been discouraged from seeking mammograms because they might not be terminal when they reach 50.

"Studies" used to say smoking wasn't bad either.

You can decide not to be tested and that is your choice you can live with it but discouraging others is WRONG.

[Generic Other]

74. Are you disputing the numbers? Or just reacting?

Women used to be given radical masectomies with no say in the matter. That was how the medical community dealt with breast cancer. One didn't even get to make an informed choice at all. Women objected, so the medical community changed the practice. I am certainly NOT discouraging other women (particularly any woman with a family history) from having mammograms. I am just looking realistically at the numbers.

I also read some of the studies about women in Europe who have fewer mammograms and fewer incidences of breast cancer than their American counterparts. I have to wonder why. And it always comes back to me not trusting the method of testing. Irradiating breast tissue is not without danger. And if the end result is that we perform more unnecessary procedures because of false positive readings, I have questions its effectiveness. Why subject healthy women to such dangers when the numbers don't support the level of alarm? I am not wrong for raising those questions.

I am concerned about overdiagnosis and overtreatment because the medical community has given me reason to believe they have this propensity. I realize this is a contentious issue. I have never even discussed it publicly before because I knew that my making decisions about my own health would draw criticism from those who put their faith in the medical community's constant as quicksand advice to us about what we must do or not do. I also know that they do not always seem to act simply for altruistic reasons.

Instead of criticizing women with legitimate concerns, shouldn't we all be asking for more research and better screening methods?

[Robyn66]

76. I am in favor of surviving into old age

If people with your "legitimate" concern makes it more difficult for someone my age to get a mammogram then your "legitimate" concern would be responsible for the cancer I had to go from survivable to NOT survivable.

Obviously better diagnostic tools are to be pursued at all costs. But don't you dare criticize my point of view unless you have walked in my shoes. You can sit there with your theories when the simple facts are that if you don't use what exists now, women will die. Its that simple.

If you have a false positive-congratulations you don't have cancer

If you have a false negative you have a better chance catching it getting a mammogram every two years than waiting 10.


Maybe you don't think cancer is a big deal and you would make no difference to you if you were diagnosed at stage 1 or stage 4 but it makes one hell of a difference to me.

If you don't want to get a mammogram don't get one, no one kidnaps you out of your house and forces you at gun point to get one. But DO NOT LULL women into a false sense of security by saying they don't need them or making them think there aren't LIFE THREATENING results of waiting another 10 years for your first mammogram.

So please, wait until the test YOU WANT is available but understand by perpetuating the lie that women under 50 don't need mammograms or that mammograms for women under 50 don't save lives or that there aren't ENOUGH women who DIE because they don't get mammograms under the age of 50 IS FUCKING WRONG. And don't accuse me of just reacting I am a fucking cancer survivor so I have EARNED THROUGH MY EXPERIENCE credibility on this issue. You find me some under 50 women with Breast Cancer who think that Mammograms are not necessary or not a good thing to have? Just to to breastcancer.org. Those strong and wonderful women helped me through and I bet there is a forum where they will even talk to the know it all's who have no idea what it is to go through cancer.

[Generic Other]

78. You are effectively silencing me on this subject....again

I'm sorry I said anything.

[Robyn66]

79. Oh no God forbid you must know more

[Bobbie Jo]

10. K&R

:applause:

[Bitwit1234]

12. My doctor told me

sonograms were much better at catching any type of abnormality. And it is less painful and gives a better picture.

[tonysam]

13. I think you need to read the actual report

Annals of Internal Medicine


Snip:


The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms. (Grade C recommendation)

The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation)

The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. (I statement)

The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. (I statement)

The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation)

The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer. (I statement)

[mike_c]

15. odd-- why the recommendation against clinicians teaching self-examination....?

Any thoughts? I haven't read the report, so apologies in advance for taking the easy way to seek clarification.

[tekisui]

16. The simple answer is they were found to be statistically useless.

If they were not found to improve detection, they may leave some women with false security.

[mike_c]

18. thanks-- that makes sense....

Note to self-- remove "breast examiner" from the list of possible career alternatives with socially redeeming characteristics. Damn.

[eomer]

29. It might make a good hobby. n/t

[Berry Cool]

36. Can we can the sexist remarks on this topic, please?

Thank you.

[Robyn66]

39. That is just offensive on this thread

I have a great sense of humor but not when it comes to this topic. So not appropriate.

[ohheckyeah]

19. I think once again it's because

of so many false positives so they are statistically not very helpful. Women's breasts change in the way they feel according to hormonal changes, weight changes and even for some women such as myself according to my caffeine consumption.

[Robyn66]

22. I can only speak from my experience but

The tumors in my breast were not detectable by touch. To try and describe it, it was like cancer buckshot all through the breast. So I would imagine relying on self exam is not the best idea.

But here is the problem with relying on statistic, at least with someone like me.

You show a curve demonstrating women over 50 are more likely to get breast cancer.

I have no history of breast cancer in my family

Now, since mammograms are not recommended for people in their 40's I say "great, I didn't want to get one anyway" which incidentally, is what I did when they changed the recommendation from 35 to 40.

So maybe before I'm 50, the cancer grows to the point where you can feel it maybe not but the FACT of the matter is I would be diagnosed at stage 3 at best or 4 at worst.

Women are being diagnosed younger and survival rates are growing. I fail to see a down side for anyone but the insurance companies who don't want to pay for the test.

If doctors begin discouraging mammograms for women younger than 50 many many women will die that ordinarily would not have.

Whether its right or wrong, if a doctor says you don't need a mammogram until you are 50 you believe you are safe. I can guarantee that is what I would have done and I would have had a disastrous diagnosis.

I just can't emphasize that enough.

[ohheckyeah]

24. There are a lot of questions

about whether or not mammograms are actually contributing to the increase in breast cancer. Until those questions are answered, I think it behooves us to demand better testing methods. Given all the other countries who are starting to question mammograms effectiveness and safety, I really don't think in this particular case it is the insurance companies who are behind this.

I'm sorry you have been through so much.

[juno jones]

34. They are useless without real training.

For a period of years I sold my body to science while I was still in it. I helped teach aspiring docs how to do breast exams and pelvic exams.

I got to feel a plastic 'simulated' breast that had lumps in it to simulate cancer. The feeling/touch of the lumps is very subtle and often can only be felt from certain angles etc. The most important step is hardly ever taught to women. Reach way up deep into the armpit and feel for any soreness or swelling. The lymph nodes in the armpit often tell more than the breasts do.


They SHOULD be helpful, and women should be made aware, but it's going to take more than placards in the shower to make them reliable.

[ohheckyeah]

20. Some new testing inroads:

New rapid, painless test for breast cancer
PHILADELPHIA, PENNSYLVANIA. The standard screening for breast cancer involves physical examination and mammography. Mammography is notoriously unreliable and often results in unnecessary biopsies and much anxiety. Researchers at the Thomas Jefferson University now report the preliminary results of a new rapid, accurate, non-invasive, painless breast cancer screening test. The test involves collecting a very small amount of breast nipple fluid (1 microliter) with an ordinary breast pump and then analyzing its protein content using the SELDI (surface-enhanced laser desorption/ionization time of flight-mass spectrometry) technique.
The researchers tested the procedure on 20 women with breast cancer and 13 healthy controls. They found that the women with breast cancer excreted five proteins that were not excreted, or excreted in miniscule amounts, by the healthy women. Thus a protein with a molecular mass of 6500 Da was found in 75 per cent of the women with breast cancer, but not in a single one without. Similarly a protein with a molecular mass of 15940 Da was found in 80 per cent of the women with breast cancer, but not in any of the healthy women. The researchers conclude that the new technique may materially aid in detecting breast cancer in its earliest stages.
Sauter, E.R., et al. Proteomic analysis of nipple aspirate fluid to detect biologic markers of breast cancer. British Journal of Cancer, Vol. 86, May 6, 2002, pp. 1440-43

New, simple test for breast cancer developed in Japan
FUKUOKA, JAPAN. Medical researchers at the Kyushu University report the development of a new, simple test for breast cancer which is non-invasive, avoids exposure to radiation, and is exceptionally accurate. The new test involves placing an absorbent pad on the nipple and leaving it there for 24 hours to absorb the normal secretions from the area. The contents of the pad are then analyzed for the presence of carcinoembryonic antigen (CEA) using an enzyme immunoassay technique. The researchers' initial study of the new test involved 22 healthy women without any signs of breast cancer and 32 women with confirmed breast cancer. The CEA content in the pads from the healthy women averaged 0.6 units from each nipple. The amount of secretion was found to be unrelated to the menstrual cycle. The CEA content in the pads from women with breast cancer was much higher; an average of 16.1 units in the cancerous breast and 2.0 units in the non-cancerous breast. The test successfully confirmed the presence of cancer in 30 of the 32 women giving a rate of false- negative results of 6 per cent. The incidence of false-positive results was 0 per cent. The location of the densest stains (heaviest secretion) on the absorbent pad was found to be closely related to the location of the actual breast tumor. Heavy staining on the upper or lower, and outer and inner part of the pad was found to correspond with tumor locations in the upper, lower or outer or inner part of the breast as confirmed upon removal of the tumor. The researchers speculate that each CEA stain on the absorbent pad corresponds to the excretory ducts of the mammary glands that open into the nipple.
Imayama, Shuhei, et al. Presence of elevated carcinoembryonic antigen on absorbent disks applied to nipple area of breast carcinoma patients. Cancer, Vol. 78, No. 6, September 15, 1996, pp. 1229-34

Temperature sensitive pads detect breast cancer
CRANFORD, NEW JERSEY. An American engineer, Zsigmond Sagi, has developed a temperature sensitive pad which can be used to detect breast cancer in its early stages. The soft, lightweight pads are worn inside the bra for 15 minutes and are then visually analyzed for telltale signs of temperature variations. The pads record the skin temperatures across three large areas of each breast. If an area of one breast shows a temperature 2oF or more higher than the corresponding area of the other breast there is a high probability that a cancerous tumor is present. Clinical trials of the pads carried out prior to FDA approval found that they were accurate in predicting breast cancer in 80 per cent of all women and in 90 per cent of women under 50 years of age. The pad technology is particularly valuable for younger women where mammography is not very accurate and is far safer and more comfortable than mammography. The technique is, however, not suitable for women who have had a mastectomy or lumpectomy or whose breasts are mismatched for other reasons. The presence of mastitis or sclerosing adenosis can provide false postive readings due to the heat generated by inflammation. A large clinical trial of the pads involving almost 6,000 women is currently underway. This trial will compare the pad results with the results of biopsies and the participants will be followed-up for four years. NOTE: The pads, BreastAlert Differential Temperature Sensor, are available to physicians from Humascan Inc., Cranford, NJ and cost $25/pair.
Heat-seeking pads may help find early breast cancers. Journal of the National Cancer Institute, Vol. 89, October 1, 1997, pp. 1402-04
http://www.yourhealthbase.com/breast_cancer_detection.html

[BlancheSplanchnik]

32. Wow! Hope these methods gain momentum quickly. n/t

[Raschel]

21. Like you I'm angry and sad also.

And like you I waited to have a mammogram. Mostly because of the stories of false detection, and no history of breast cancer in my family.

I think this new info will have women totally confused and ambivalent about mammograms and self care.

It's a kick in the teeth to all women, and women who have worked so hard for breast cancer awareness.

Early detection is the key. As you know, once it becomes invasive it's a whole nother ball game.

I pray for continual good health for you!

[Berry Cool]

37. "Early detection is the key. As you know, once it becomes invasive it's a whole nother ball game."

NOT. TRUE.

First of all, some early-detected cancers are so aggressive they will kill anyway. Sad, but true.

Second, "invasive" isn't the same as "metastatic." "Invasive" just means it's invaded surrounding tissue. Doesn't tell you how much. "Metastatic" means it's spread to other parts of the body--and THAT is the "whole nother ball game." Doesn't mean it's fatal, but it makes a big treatment difference.

[Raschel]

38. No. You're. Wrong.

If cancer cells in the breast ducts spread through the duct walls and penetrate the basement membrane, the condition is known as invasive, or infiltrating, ductal carcinoma (IDC). From there, the cancer cells can spread, or metastasize, to other parts of the breast and other parts of the body through the lymphatic system, the bloodstream or directly into adjacent tissues.

And women are living longer every year with early detection and ajuvant therapy.

Even with such agressive forms of cancer as IBC.

[amborin]

46. exactly; my mother died from just this kind; an earlier mammogram would have given her more yrs n/t

[Raschel]

67. I'm sorry you lost your mother to breast cancer.

Like me, I'm sure you learned more about bc than you ever wanted to know. My family has as well, and I take some comfort in the fact that my daughters are educated about it.

It does happen to young women. It does happen to women with no history in their family. It doesn't always present with a lump. A very good website for info for any woman out there with concerns is breastcancer.org

It concerns me that these new recommendations will confuse so many women.
I'm glad to hear that Kathleen Sebelius and the American Cancer Society are recommending that women stay with the previous guidelines.

Nobody is a statistic.

Peace to you. :hug:

[Hell Hath No Fury]

23. So I am not supposed to do self breast exams --

and I am not to get a mammo before 50.

So how the fuckin' hell do I detect potential breast cancer if I am in my 20s 30s or 40s?? I mean really, what the fuck??? It just does not make any sense whatsoever. :crazy:

[Robyn66]

25. I say lie

if necessary. Tell the doc you have it in your family. Its not like they check. I tell every woman I know to start getting mammograms as soon as they can. I'm sorry some have had biopsies that have been painful and turned out benign but you can look at it this way, IT CAME OUT BENIGN, I would have given ANYTHING to hear that I DIDN'T have cancer.

[hlthe2b]

27. Please don't advise women to lie about family history...

This can REALLY backfire. If you feel as though your physician is not being aggressive enough in screening, express your concerns and/or change doctors. Better to say that you don't know if there is a family history of breast cancer then to lie and say that there is, when there is not. This will be increasingly more important as further genetic subtypes are identified which can dramatically change course of therapy.

Robyn66, I understand where you are coming from and appreciate your heart being in the right place, but take it from me, NEVER lie to your doctor about the presence or absence of family history for any cancer, nor other risk factors.

[Robyn66]

28. You are right

I so incredibly emotional about this and what I said was wrong. You should never lie to a doctor.

[ohheckyeah]

26. Many women go to their

doctor yearly for pap smears and have breast exams done by the doctor at that visit.

[Hell Hath No Fury]

31. IF she's getting pap smears --

she may be one of those women without isnurance to get that kind of regular care. Shit, at least a self-breast exam is free. :(

[ohheckyeah]

35. I agree and I think women

who know how and understand what they are looking for should continue. We certainly have the right to make these decisions for ourselves.

[DU GrovelBot]

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[Raven]

40. Robyn66 and I work together. I was there during her ordeal and I'm

going to tell you about it because it is every woman's story...repeated over and over and over. She's 42 and has avoided the dreaded mammogram. She finally decides to make the appointment, then almost cancels it, then decides to go through with it. She has it and they call her back. I tell her not to worry there are often false readings the first time around. They look some more and bang, the little NH hospital finds something in both breasts. More tests and they decide it's only in one breast but it looks like an aggressive cancer and it's at stage 2. I was with her when she got that news and it was terrible.

She goes for a second opinion...I REPEAT...SHE GOES FOR A SECOND OPINION!!!! THIS IS A MUST! At Brigham&Womans/ Dana Farber in Boston they redo all the tests and find that it is NOT the aggressive cancer the little NH hospital had diagnosed but it was a cancer nonetheless, less aggressive in stage 2. The first diagnosis would have dictated a chemo treatment that would have been the wrong one.

I won't recount the hell of the next several months but she is cancer free and looking to reconstructive surgery at one of the best hospitals in the world.

Now, here are the lessons I have taken from watching my friend go through this:

- A false positive would have been a horrible trauma but better than not being diagnosed at all and waking up at 50 to face a death sentence. So this crap about saving our poor weak sex from the discomfort of a mammogram and a false positive is pure crap. I think we know what's good for us and screening starting at 40 is good for us.

- Robyn had very good health insurance, many people don't. All we need is another obstacle to preventative care. If insurers stop covering this, women are going to spend their precious time fighting for coverage while the cancer grows and grows.

-Robyn had very good health insurance and it is everyone's right to have it too. We need to pass HCR so that every woman will have the access to good health care that Robyn has.

- Her strength and courage, a wonderful husband and good friends and good docs got Robyn through this...it is a terrible disease and we need to be fighting it not a bunch of bureaucrats and insurance companies.

- And last but not least...if you are diagnosed with something like this, GET A SECOND OPINION...GET IT!

Enough! I'm done.

[Robyn66]

45. Thank you!!!

I was starting to feel like I was screaming into the wind!!!

[hlthe2b]

62. Excellent points, Raven...

Particularly on the benefits of a second opinion...

[bdamomma]

66. wonderful post.

and I agree with getting a second opinion too.

[zbikerwy]

81. is second opinion going to be an option

with the new health care reform ???, the insurance i have now allows this but from what I'm reading as everyone is slowly forced into the government option this will vanish, you only get one opinion and theirs is the one that counts, god i hope we are not losing something so critical as free choice as to whether we can have a second opinion or not like it says in the senate bill.

zbiker

[David Zephyr]

44. K&R right to the top.

Robyn66!

[dflprincess]

48. I'm one of those who may have had an "unnecessary biopsy"

and did, indeed, suffer "much anxiety".

Last year the mammogram looked odd, the core needle biopsy while not finding any cancer cells wasn't "benign enough". The surgical bioposy came back benign but "atypical". The problem with breast cancer is that no one knows enough about what a diagnosis of "atypia" means. They know that some forms may indicate a higher risk for cancer and other cells are just not normal but never going to be cancerous and may even be knocked off by your own immune system. They even know that it's possible to have cancer cells that just sit there until you die when you're 90 from a heart attack.

I'm also over 50 and past menopause so even if I did develop breast cancer it's more apt to be slow growing. I can kind of see the every other year for post menopausal women because of this but my doctor once told me that the younger a premenopausal woman is when she gets cancer the more aggressive the cancer is apt to be so I'd think it makes sense between 40 and 50 to have an annual check.

Personally, I've decided I'd rather have the unneccessary biospies (and the surgical one was easier than the core needle one as far as post procedure discomfort went) and the anxiety than have a malignant tumor missed and allowed to grow for an extra year. Of course, last year I also had insurance that covered most the expense (it came to over $6,000 from first mammogram to last biopsy) next year, I'd have to find about $2,000 of the cost. I always wonder about the outfits that offer free screening mammograms for uninsured or underinsured women - they never say if they help if the test come back needing follow up.

[amborin]

49. Drs. & Cancer Experts Oppose this new guideline: article:

<http://news.yahoo.com/s/afp/20091118/ts_afp/healthuscancerbreast_20091118024608>

[Nikki Stone1]

52. You and all of us

:kick:

[Manifestor_of_Light]

53. Insurance companies are being cheap bastards.

I had three biopsies done in between 39 and 45 -- they were just calcium deposits but they needed to be done!!!

My mother had breast cancer diagnosed in 1979. It was a mixed tumor with 3 kinds of cancer in it. She had a dimple under her breast, pulling the skin in. That was back when they said to watch out for lumps, not dimples. She was small breasted. She had a radical and they could barely get the skin to meet. It was in four lymph nodes. She would have been dead within a month or two had she not gone to the doctor about the dimple. She had radiation and chemo and lasted another 23 years.

She had gotten her mammograms every year like she was supposed to. This is when they were blue ink on white paper, some kind of xerox process. They showed NO SIGN of any malignancy or abnormality.

My sister worked for the head of Pathology at M. D. Anderson Hospital, the largest cancer hospital in the world.

She took our mother's films from 1978 to the doctor who was the Chief of Radiology at M.D. Anderson Hospital. He went over those films with a magnifying glass and saw NOTHING ABNORMAL.

That is scary when one of the world's experts sees nothing abnormal in a mammogram from someone with infected lymph nodes and three different kinds of cancer in one walnut sized tumor.


Tonight Katie Couric was talking about false positives on mammograms. From my experience with my mother I think they should start talking about false negatives. Mom used to stand up at cancer conferences and ask the doctors what the false negative rate was. They refused to answer her, and I think at the time it was about 15%. That is not reassuring.

[Maraya1969]

56. Please stop using deodorant from the drug store. Use only natural

stuff like Toms. http://www.tomsofmaine.com/products/deodorant.aspx

What I read about it makes a lot of sense. Women shave their arm pits and then put deodorant on right away so it gets sucked into the pores easily. Men don't shave and that is one of the reasons they say that men don't get breast cancer as much as women. The fact that they plug up the pores seems to be a problem too. I take baths with epsom salts. They draw out impurities from the body.

I know aluminum used to be a concern. I found this information. It does not say that there is definitive conclusion but I would rather not take the chance

http://www.cancer.gov/cancertopics/factsheet/Risk/AP-Deo

What do scientists know about the ingredients in antiperspirants and deodorants?

Aluminum-based compounds are used as the active ingredient in antiperspirants. These compounds form a temporary plug within the sweat duct that stops the flow of sweat to the skin's surface. Some research suggests that aluminum-based compounds, which are applied frequently and left on the skin near the breast, may be absorbed by the skin and cause estrogen-like (hormonal) effects (3). Because estrogen has the ability to promote the growth of breast cancer cells, some scientists have suggested that the aluminum-based compounds in antiperspirants may contribute to the development of breast cancer (3).


:hug: :hug: :hug: :hug: :hug: :hug:

[tavalon]

57. Most breast cancer is found in women over 50 years

but I think at least every other year starting at 35 would be best. It doesn't matter one iota if the numbers are in your favor if you personally get cancer.

I have a catch 22 in my situation. As a young and dumb 20 something, I just had to have a breast augmentation :eyes: and of course, they got encapsulated. Now I'm 46 and if I get a mammogram, my implants will get ruptured and I'll have to have surgery but they won't give me an MRI until I get a screening mammogram. Lovely! I've decided, for now, to gamble. It sucks and I hope I'm on the right side of the odds.

I'm glad you got your mammogram when you did.

[Coventina]

58. I hear you, sister!!! I'm angry as well. I have chronic breast disease.

And I've needed frequent mammos & ultrasounds(sometimes more than one a year) since my early 20s.

This "study" is going to cost lives.

:mad:

[graywarrior]

60. My nephew's wife (they just got married last week) was 20 when a mammogram found breast cancer

20! She's now 25 and pregnant (risky, but she's happy). Had she not had a mammogram, she'd be dead now.

[hlthe2b]

61. It is very unusual to have had a screening mammogram at that age

unless she had significant family history of breast cancer or perhaps she or her doctor felt a mass on exam? ' I'm very glad to hear a happy outcome. Best wishes to her and your entire family.

[bdamomma]

64. in regards to your comment or statement here:

"Now, some government panel is saying women don't NEED mammograms until they are 50".

how many men are on that government panel?? just wondering.

[marshall]

65. I think the real issue is statistics and use of resources

While mammograms at younger than age 50 will of course catch some problems, is it a high enough occurrence to warrant the use of limited resources? A redistribution of the funding might in the long run benefit a greater number of people.

[Quantess]

69. Mammograms are "limited resources"?

[marshall]

70. Health care is ultimately a limited resource

Both money and time wise.

[Robyn66]

71. Oh so there are acceptable losses?

The women who end up with terminal cancer because they got a mammogram 10 years too late just shoudl deal becaus there just wasn't enough HEALTH CARE? Would you think that was ok for your mother sister daughter girlfriend?

[marshall]

72. That's not my opinion

That's how I think the powers that be look at it.

[Robyn66]

75. Im glad you don't feel that way

I'm sorry I jumped like that. I have just been through so much and I will admit I am completely emotional about it and cannot beleive some of the bullshit arguments in favor of this I am seeing!

[Bobbie Jo]

77. Kick