Can we talk MAMMOGRAMS?

[Heather in Neverland]

I keep getting all this conflicting information and it is making me a little crazy.

 

My regular family doctor in the states said I should start getting them every two years at age 35.

 

My ob/gyn in the states said yearly starting at age 40.

 

I went to a new ob/gyn here today (what a great doctor!) and she said with no family history and no extra risk factors they recommend age 50.

 

So which is it?

 

And why all the discrepancy? I mean if there is a "correct age" to start then why isn't it the same everywhere?

[Amy+2]

Well...my OB in Ohio required me to get a Baseline at age 35. NO family history at all.

 

I am not sure how I feel about it. I do believe that the less you expose yourself to the radiation, the better. That being said, if I had a family history, I think I would be more aggressive with preventative measures.

 

My new Dr. in Texas, who is a female, said there was no need for me to have another one at this time. I just turned 40 and expected to have to have another. I must say I was relieved that she didn't feel it necessary.

 

So, after reading what I have typed here, I don't think I am much help!:tongue_smilie: I do know that a while back, if I remember correctly, there was some hoopla over what age was deemed to be appropriate. I have no doubt others will be chiming in!:D

 

BTW, did you put the book to rest?!?:lol: I say don't finish it!

[LuvToRead]

 

I went to a new ob/gyn here today (what a great doctor!) and she said with no family history and no extra risk factors they recommend age 50.

 

 

This is what my ob/gyn just told me. He said they recently changed the recommendations.

[Perry]

I keep getting all this conflicting information and it is making me a little crazy.

 

My regular family doctor in the states said I should start getting them every two years at age 35.

 

My ob/gyn in the states said yearly starting at age 40.

 

I went to a new ob/gyn here today (what a great doctor!) and she said with no family history and no extra risk factors they recommend age 50.

 

So which is it?

 

And why all the discrepancy? I mean if there is a "correct age" to start then why isn't it the same everywhere?

Depends on who you want to listen to. There is a good explanation here. In a nutshell, earlier screening doesn't improve survival all that much (but does find more cancers), and does increase harm. So it's a risk-benefit issue, and different groups have come to different conclusions.

 

If you want a perspective of a breast surgeon, Respectful Insolence has a post about mammography recommendations here.

 

The reasons for recommending delaying until age 50:

 

The USPSTF found fair evidence that women who have screening mammography die of breast cancer less frequently than women who do not have it, but the benefits minus harms are small for women aged 40 to 49 years. Benefits increase as women age and their risk for breast cancer increases. However, there are relatively few studies of mammography for women aged 75 years or older. The potential harms of mammography include anxiety, procedures, and costs due to false-positive results and receiving a diagnosis and treatment of cancer that never would have surfaced on its own within a woman's natural life time. They found that the benefit of mammography every 2 years is nearly the same as that of doing it every year, but the harms are likely to be half as common. They found no evidence that self- or clinical examination reduces breast cancer death rates.

 

and

 

That's why it's important to understand on what evidence these recommendations are based. It might help if you go back and read a post I wrote last week that discusses a review of the literature that urged a rethinking of screening mammography. In that article, it was estimated that, for women between the ages of 50 and 70, 838 women have to be screened for over 5,866 screening visits to sayve one life. It often shocks people to hear these sorts of numbers, but they are not beyond the pale for screening programs. More importantly, the USPSTF based its update of its 2002 recommendations on newer studies, including a study included in the same issue of the Annals of Internal Medicine that used several models to estimate breast cancer risk reduction using various screening paradigms, as well as newer randomized clinical trials, such as the Age Study and updated Gothenberg trial data. These models and results are consistent with randomized clinical trial results that indicate that there is a reduction in breast cancer mortality that results from beginning screening at 40 years but the reduction is "modest and less certain than mortality reductions observed from screening women aged 50 to 69 years." By using data from randomized clinical trials, the USPSTF estimates that averting 1 death from breast cancer requires screening 1,904 women aged 40 to 49 years; 1,339 women aged 50 to 59 years; or 377 women aged 60 to 69 years. As described above, there was little difference in the benefits between screening every year versus screening every other year, but there were considerably more harms.

[Carol in Cal.]

I thought it was at 40, but maybe it was at 35. Then this could be compared with future ones, if any ever found anything.

 

Earlier than 30, the tissues are too dense for a routine mammogram to be effective in distinguishing between cancerous and non-cancerous material. The implications of that are annoying.

[Pamela H in Texas]

They recently changed the recommendations.

 

What *I* would do:

 

Age 35

Age 40

Probably 45

Then every other year from 50 on.

 

Not sure.

 

Anyway, my first mammo was at 31. Sonogram was also done at that time.

 

I know they say we don't need them in our 30s and 40s but seriously, ONE life is too many too lose, imo. It's a quick, easy test. I say do it.

[Heather in Neverland]

well I turn 40 in August and have never had one so I am starting to think should I? should I not? and the conflicting informations is...well...conflicting!

[pdalley]

I had my first at 39 due to family history - my maternal grandmother had a radical mastectomy after the discovery of a cancerous lump. (No reoccurrence after twenty five years though - which is super - she has a mammogram on her remaining every five years or so)

 

Her mother had died of suspected ovarian/breast cancer during the Depression so the family history is strong. They discovered a lump - turned out to be fibrous and nothing to worry about. I had my next one at 42 and it was completely normal.

 

My mother shuns any doctors unless dying (I'm not exaggerating though I wish I was) so we have no history on her. But I'm certain my OB will probably want one yearly due to the family history. I wouldn't want one once a year if there wasn't such a strong history in our family.

[MBM]

My SIL had her annual mammogram done and several months later was diagnosed with stage IV breast cancer. She found the tumor -- the size of a golf ball when it was removed -- while doing a self check. It was located just below her armpit. Just a reminder that self checks are a must.

[Holly IN]

Both of my family dr and OB/GYN told me that the St. Vincent recommendation is:

Cancer history start mammogram at age 30 then every 2 years.

 

No cancer then start at age 35 but if anything shows such as a lump (non cancer or cancerous) will have to have a mammo every year or every two years otherwise the 2nd one at age 40 then two years after that unloess something shows.

 

This is in INdiana btw!!

 

Holly

[JeneralMom]

I am 38 and have never even had a mammogram mentioned to me by any of my doctors. I have no family history of breast cancer, so maybe that is the reason.

[Wheres Toto]

I had my first mammogram at 33 when my doctor found a lump during a visit for something completely different. It was inconclusive so led to an ultrasound and lumpectomy/biopsy. It was benign but I have some family history - maternal grandmother, maternal aunt both had breast cancer but possibly metastasized from lung (heavy smokers both). I do have a first cousin who had breast cancer leading to a masectomy at 40 years old.

 

I had a second mammo at 35, then not again until 40 (last year) but part of that is because I was pregnant and/or nursing non stop from 35 to 39. Right now my doctor is still recommending I go annually.

 

Edited to add: Statistics are interesting but if the one life that is saved by screening between 40 and 49 is your own, or your mother/sister/best friend - then it's hard to say it wasn't worth it.

Edited June 16, 2010 by dottieanna29

[Sara R]

I know they say we don't need them in our 30s and 40s but seriously, ONE life is too many too lose, imo. It's a quick, easy test. I say do it.

 

It's not a matter of "one life is too many to lose." It's a matter of, do mammograms work well enough for premenopausal women. (The answer to that question is, no, not really.)

 

It's not that young women don't die of breast cancer. They do. It's just that mammograms don't find the cancer well enough. IMO there is a urgent need for an effective, non-invasive screening test for young women. I think that would be the most effective place to pour money into breast cancer research.

[KatherineNaomi]

It's not that young women don't die of breast cancer. They do. It's just that mammograms don't find the cancer well enough. IMO there is a urgent need for an effective, non-invasive screening test for young women. I think that would be the most effective place to pour money into breast cancer research.

 

I agree. I'm 34 and was diagnosed two weeks ago with breast cancer (DCIS). It was not detected on either a mammogram or ultrasound. It was a surprise finding that was found upon the surgical removal of a benign tumor in my milk duct that was causing nipple discharge. Had the benign tumor not been there it probably would have taken years for my cancer to show up on a mammogram.

[Mrs Mungo]

I keep getting all this conflicting information and it is making me a little crazy.

 

My regular family doctor in the states said I should start getting them every two years at age 35.

 

My ob/gyn in the states said yearly starting at age 40.

 

I went to a new ob/gyn here today (what a great doctor!) and she said with no family history and no extra risk factors they recommend age 50.

 

So which is it?

 

And why all the discrepancy? I mean if there is a "correct age" to start then why isn't it the same everywhere?

 

The military pays for one for one a year, starting at age 40. However, if you have a strong family history of breast cancer, they do it earlier and they will do a yearly MRI.

 

It's not a matter of "one life is too many to lose." It's a matter of, do mammograms work well enough for premenopausal women. (The answer to that question is, no, not really.)

 

It's not that young women don't die of breast cancer. They do. It's just that mammograms don't find the cancer well enough. IMO there is a urgent need for an effective, non-invasive screening test for young women. I think that would be the most effective place to pour money into breast cancer research.

 

I agree. I'm 34 and was diagnosed two weeks ago with breast cancer (DCIS). It was not detected on either a mammogram or ultrasound. It was a surprise finding that was found upon the surgical removal of a benign tumor in my milk duct that was causing nipple discharge. Had the benign tumor not been there it probably would have taken years for my cancer to show up on a mammogram.

 

Right, mammograms are designed to look for changes. They won't see them if it's your first time and they are harder to see in denser breast tissue.

[RhondaM.]

I agree. I'm 34 and was diagnosed two weeks ago with breast cancer (DCIS). It was not detected on either a mammogram or ultrasound. It was a surprise finding that was found upon the surgical removal of a benign tumor in my milk duct that was causing nipple discharge. Had the benign tumor not been there it probably would have taken years for my cancer to show up on a mammogram.

 

:grouphug: I am so sorry for your diagnosis. I was diagnosed with the same in September/October of 2008. breastcancer.org forums were a blessing to me.

 

I found the lump myself. 2-3 years before I had had a mammogram that found nothing. It was clear as day on the ones they took after my diagnosis. Quite wide spread too.

 

Anyway...I agree that they need to find a non-invasive breast exam.

 

I also think self-exams are VERY important.

 

RhondaM.

[dancer67]

I think this is a personal decision. I had one done last year at age 41 because a friend strongly urged me to get one. So I did it to make her happy. For me quite frankly, I will not get another one until I am 50. There is no history of BC in my family. And the exposure from all that radiation tends to make me think you are awakening a beast that may sleep forever.

 

Self checks, I believe are more important.

 

Good luck with your decision.

[Heather in Neverland]

The doctor also said that my breast tissue was very soft and therefore any lumps are easy to find.

 

I think by "soft" she meant "saggy". :tongue_smilie: