My Little Bs Have the Big C

A Breast Cancer Blog For Young Women


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A Reaction To The American Cancer Society’s New Mammogram Guidelines, Written By One Of “Those Women”

guidelines

Progress

– A movement toward a goal or further to a higher stage.

developmental activity in science, technology, etc., especially withreference to the commercial                 opportunities created thereby or to thepromotion of the material well-being of the public through the goods,techniques, or facilities created.

growth or development; continuous improvement

In science, in cancer, we are always looking for the next best thing.  The next best medicine, procedure or test as a way to prevent deaths from a  disease or even to prevent the disease from occurring.  That’s why we have clinical trials, to test out the latest and greatest theories and see how they work.  Some of them fail, and we learn from those failures but some of them succeed.  Like Tamoxifen, Herceptin.  These are both example of incredible progress when it comes to the treatment of certain types of breast cancer.

But sometimes, what one calls progress isn’t universally so.  What I’m referring to is the American Cancer Society’s new mammogram guidelines.  The changes are as follows.  Women should start getting routine yearly breast exams starting at 45 years old.  The old recommendation was 40.  They also say that women can skip manual breast exams altogether.  After age 55, women can switch to a mammogram every two years if their scans have previously and consistently been clear.

The American Cancer Society sites a few reasons for this change.  One reason is that a young woman’s breast is more dense than that of an older woman, making the detection of breast cancer much more difficult.  Dense breast tissue shows up white and so do tumors.  This creates more false positives in young women.  In an article for CNN, one doctor said, “If she starts screening at age 40, she increases the risk that she’ll need a breast cancer biopsy that turns out with the doctor saying ‘You don’t have cancer, so sorry we put you through all this,'” Brawley said.

Many women feel like this is a risk they are willing to take.  What’s a few biopsies when, in the end you either a) have peace of mind or b) have been diagnosed with breast cancer but, hopefully it has been caught in time to receive life saving treatment.  Acknowledging this, the ACS says that concerned women should get mammograms if they want to.  They’re not saying, “don’t do it,” but they are saying that women can reasonably wait five more years.

But what about all of those women who might develop breast cancer between the ages of 40-45?  Or younger?  What if, because they were not screened due to the new guidelines, their cancer is not caught in time for life saving measures but only life extending ones?  This is the concern that many women have.

The other reason that the ACS is making this recommendation is the hysteria caused by breast cancer screening.  Dr. Brawley, in the same interview said, “False positives are a huge deal.  These women are so frightened and inconvenienced they swear off mammography for the rest of their lives.”

These women.  THESE WOMEN?????!!!!!!!

This is where I have my biggest problem.  This statement, in my opinion, further perpetuates the notion that women are not in control when it comes to their emotions, especially fear and anxiety.  That we are fragile and not strong enough to handle the scary process that is required for our basic health.  We are delicate flowers who can’t take the heat.  Are women so frightened by cervical cancer that we refuse pap smears?  I’m sure it happens but it’s not common.  Just like I’m sure some women are traumatized by a false positive that could occur with a mammogram so they never go back again.

But I like to think that most women, despite all of this, put their health first.  I think that is what is true.  I think that is the majority.  Although I don’t have any statistics to back this statement up.  It’s just my feeling about my fellow women.

Let me tell you what is truly frightening about all of this.  My fear is that without regular manual breast exams and mammograms, more women without a personal family history or genetic mutation will not get their cancer detected until it is too late.  I’m scared that in the next few years we will see an increase in breast cancer mortality, especially in young women.

So here’s my real problem.  As of today, there is no effective tool for detecting breast cancer in young women, other than self breast exams.  I’ll say this again, THERE IS NO TRULY EFFECTIVE TOOL for detecting breast cancer in young women.  And the one way that we have, manual breast exams (which is how I found mine, by the way) they want to do away with!  So, why instead of decreasing ways women can get screened is there not a focus on rigorous and early detection in women under the age of 40?  I’m not saying this is easy.  I’m saying it’s necessary.

Being a woman in America just got a little scarier.  But don’t tell the American Cancer Society.  They just might set new guidelines so as not to paralyze us with fear.

Young Survival Coalition’s response to ACS’s new guidelines.

CNN article with video

New York Times article

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No Cost Mammograms in Brooklyn

Hi,

Just and FYI to my NYC peeps.  You can get no cost mammograms in Brooklyn next Wednesday, September 30.  Here”s the link.  http://karmabrooklyn.blogspot.com/2015/09/no-cost-mammograms-detect-breast-cancer.html

mammography saves lives


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My Second Ever Mammogram

Yesterday I had my second mammogram.  We all know how the first one turned out so going into this experience I was understandably nervous.  The process of actually getting a mammogram is not bad.  It doesn’t hurt (I know a lot of women fear that it will).  It’s just unpleasant.  No one wants their boobies panini pressed.  But it’s just one of those things you have to do to maintain your health as a woman.  Here is a bit of the process.

1. After you check in and give all of your info, you go into a changing room and take off everything from the waist up.  They give you a pretty robe to put on, you take a selfie in said robe and then go into a waiting room with other women in the same robe and wait for them to call your name.

image12. They call your name and you go into the room with the imaging machine.  I don’t know if all mammogram machines are like this but the ones at NYU change color.  To keep you occupied?  Distracted?  Optimistic?  I don’t know.  But it’s a slow, psychedelic show.  Then a nurse gives you a wipe to remove your deodorant.  She is also the one who will position you and take all of the images.

image2 image3 3.  The images are then sent to the radiologist for examination.  You go back into the waiting room with the other women.  At this point one of two things can happen.  One, you are given the all clear and given a slip to make your next appointment in a year or so.  Or two, you will be called back for more imaging (for various reasons: closer examination, an image was blurry, they see something they don’t like).

I got option #2.  Three images were taken of my left breast and after sitting in the waiting room for 10 minutes, watching women who went in after me leaving with their purple slip and smiles on their faces, I started to panic.  They said that they wanted more images and called me back into the room.  I started to cry.  It was complete deja vu.  In my mind, there was only one reason why they wanted to see more.  Cancer.  Again.

The first time I had a mammogram of my left breast, (which was when my right was diagnosed) they thought they might have seen a cancer there as well.  Further testing showed that what they were seeing were scattered calcifications and not clusters (which would signify a possible tumor) and my MRI showed no signs of cancer, so I was given the all clear.  My fear all along is that these were specks of cancer everywhere, just waiting to grow and spread.  When they called me back into the room yesterday, I was sure that my prediction had come to fruition.

After they took two more images, I waited once again in the waiting room.  Alone.  Everyone else had gone.  I was the last patient.  Probably about 5 minutes later they asked to see more.  “We’re going to take just one more image.”  I began to shake.  I was shaking so badly that they had to repeat the image several times because it was coming out blurry.  Frankly, I’m glad I didn’t pass out or puke.  That’s how frightened I was.

I was sent into the waiting room again.  Five minutes passed and finally the radiologist came out to talk to me.  The same calcifications that they saw six months ago are still there.  They had not changed or grown.  They said because of my history and my family’s history with breast cancer, they wanted to be extra cautious, which is why they kept repeating images.  They are not completely sure what these calcifications are.  It could be signs of dense breast tissue since I’m so young but they are not completely ruling out the beginnings of cancer.  They wouldn’t dare.

The radiologist said that if they were very concerned they would send me for testing but since there has been no change in the last six months and my previous MRI was negative, they were comfortable sending me home.  I have my fears and doubts.  What if they let this go and six months later there is a growth and we could have done something about it now?  What if I get cancer again?  Can I do this whole process over again?  I’m strong now but I don’t think I could be strong again.  Not like this.  And if it is all over my breast, will it be all over my body?

Ultimately, she did not think this was the case but wants to keep a close eye on me.  I have already scheduled my next mammogram for six months from now.  Around that time I will also get another MRI, which will tell us more.

I just don’t know why every step of this process has to be constant torture and trauma.  I don’t know why I have to live my life in constant fear.  I will be living the rest of my life in fear.  I am so scared.