Reply to Interesting research on the over diagnosis of breast 'cancer' due to mammograms

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I was reading up about breast density in light of these new laws being passed and the new "know your breast density campaign".

Something to consider: if you are pre-menopausal, you usually have more dense tissue. Age 50 was chosen as an arbitrary age because a great number of women who are menopausal are 50 or older For women (like myself) who are not menopausal, my tissue will be denser.

For a pre-menopausal woman with no lumps, no issues, no history in the family, a mammogram can actually do more harm than good, especially psychologically because you are much more vulnerable to call-backs. Which is why the recommendations were switched to start at age 50, not 40. You are also much more likely to go through further invasive testing.

I noticed on the forms I filled out, they did NOT ask if I was still menstruating. So the radiologist has no idea if I am pre-menopausal or post-menopausal. All they have is the age of 53, and they will make assumptions based on that. Not really good medicine, eh?

So I will not heed any potential recommendations for further testing simply based on breast density. They will have to tell me they found something, show me what it is on the x-ray, and tell me why they want to explore further. After menopause, that thought process will change.

I did ask the doc at my gyno about it and she agreed that the false positive risk was high and it's a balancing act.[/quote]

Where I get my mammograms they do ask. But its somewhat irrelevant. I am well past menopause and still have dense breasts. The issue with breast density is not that it increases your risk but that it makes mammograms difficult to read. A good facility will ask for a magnified view of an area of density so they can get a better look.

-- signed, someone whose breast cancer diagnosis was delayed because the tumor wasn't seen due to breast density[/quote]

Actually, they claim it to be a separate risk factor.[/quote]
Would you please put that in perspective to the other risk factors?[/quote]

From my research, if a woman is premenopausal, dense breasts are simply supposed to be like that. Which is why routine mammograms are not being recommended anymore for women 40-50 without other risk factors, like family history. Too many false positives, risk of false negatives leading to unnecessary tests - and unnecessary stress!

After 50 - an arbitrary number btw as it was picked because it's assumed most women are menopausal by then - breasts tend to be less dense, so mammograms start. However there is a subset of women who's breasts remain dense and those women are at a higher risk, but only minimally, unless, again, there are other risk factors. There is a formula doctors use to assess your personal risk and I think the risk factor or dense breasts only is about 1% more. Given the high false positive rates of MRI and Ultrasound, it's just not worth the additional testing unless it's something that you personally want, and feel comfortable knowing that false positives leading to biopsies are a distinct possibility

When the breast density law was being considered in VA, radiologists were quietly lobbying against it, and managed to get the wording of the information letter that goes out to the patient changed, to say no additional testing is necessary unless there are other risk factors. Reason being, they felt women would feel mammograms useless for them, and they would not get them at all.

I am 53 and still get my period every month like clockwork. My breasts are dense. I will not go for additional testing simply for that reason. My body, my choice. In two years, if the 3-D mammograms live up to their hype in that they REDUCE the callbacks and false positives, then it's worth doing that. The trade-off is they find more and smaller DCIS which can lead to over treatment.

What's really needed is a breakthrough in tumor typing, i.e. which DCIS or LCIS is going to stay indolent and which one will not. Cancer is only deadly if it metastasizes. 
[/quote]

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