Isn't It Ironic

How ironic this should be in the headlines on CNN today: 
New Breast Cancer Guidelines: Screen later, less often
This article has more detailed information, too.

This part was particularly disturbing to me:  "...and that everyone can skip the routine manual breast checks by doctors."  Since my doctor actually was the one to find the lump in my breast last year it seems kind of important... especially if you don't know exactly what you are looking for when you do a self-exam, which pretty much every woman my age I've ever talked to has said.

Ladies reading this... please continue to let your doctor do an exam just in case!  I don't understand why they would recommend not doing this... It doesn't cost any extra money... and if you are already going to see your doctor who has been trained to do a clinical breast exam, why would you not have it done while you are there?

This morning I had my first follow-up mammograms.  It was my first time back to the breast imaging center since my surgery in January.

It was so nice to hear that the radiologist said they looked just as they would expect and nothing concerning to be seen.  At the same time... the mammograms I had last year also looked normal.  It was ONLY because my doctor had felt that lump that I also had an ultrasound which did show an abnormality.  Because of this, I don't have a lot of confidence in my mammogram... I guess I have more on an issue regarding "younger" women and mammograms because I worry they won't show anything... that's more concerning to me than showing something that turns out to be nothing.

One of the primary reasons for the new guidelines according to the article above is that the chance of false positives is higher in women under age 45.  "The chances of false positives are especially high for women under 45, as they have denser breasts and tumors are harder to spot on an image. "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."

So, my take is they are saying the mammogram could show an abnormality of some sort, which could require a biopsy, which very likely would turn out to be nothing and thus you went through that stress for nothing.  And for this reason, we just shouldn't screen women under 45 at all.  

Being told you need to have a biopsy is very stressful.  Having a biopsy is scary because it might hurt and they are going to stick a needle in your boob.  Not something that sounds (or is) fun.  But the real reason it is scary and stressful, is that you might have cancer!  You might play off that you are mostly scared it will hurt, but I think most people are more scared about the cancer part.

It is unfortunate that we don't have a screening test that would tell you right up front if a mass was cancer or not.  It is unfortunate that a woman might go through the stress and worry of having a biopsy "for no reason."  But I'm jealous of that woman.  I wish I would have gone through my biopsy for nothing.  I wish I would have gotten a call from someone saying, "Sorry we put your through this, it's not cancer."  In my mind, it really isn't for nothing, it's to make certain you don't have cancer.

Maybe I would have been annoyed I had to go through all that for what turned out to be nothing.  Mostly I think I would have felt relief and gratitude!  Because after you have a biopsy, all you think about is if you have cancer or not.  Maybe your boob is a little sore and you have to ice it, but mostly that just reminds you that you might have cancer.

And you wait for the phone to ring.  And when it doesn't, you call the office to ask if they have your results yet (no).  And then after forcing yourself to wait until at least 2 o'clock, you call back the next day, too (hey, they said 2-4 days and we're in that time frame!).  And you try to imagine what it will be like when they finally do call.  You imagine them saying, good news, it's nothing.  Sorry you had to go through this.  Hearing those words would be totally awesome.  I guess I did get to hear that after my second biopsy.  It was awesome.  I didn't feel angry that I had to have the biopsy, I just felt thankful there was no more cancer.  Although at the same time, I already had cancer so it was a slightly different experience.

And so, in my mind, that reasoning is kind of a load of crap.  I'm pretty sure most women under the age of 45 who has been diagnosed with cancer might agree.  What is scary to me is to think about the woman who might have had cancer detected by a mammogram or clinical breast exam when it was in an early stage.  But she didn't, and by the time they find it, it has spread and her prognosis is much more grim and treatment much more intense.

Research shows that 1 in 8 women will be diagnosed with breast cancer in their lifetime.  That seems like a lot.  And that is based on the sole "risk factor" of being female.  I hope that despite these new guidelines, insurance companies will continue to cover breast cancer screening for women age 40-45 if they choose to be screened.  I really hope they can keep improving the technology to detect breast cancer (and all cancers).  And to any woman who is mad that she had to go through the stress of a biopsy or other tests only to be told she does not have cancer, you might want to reassess and realize how thankful you should be.