I think all the press about “early detection saves lives” gives the false impression that all cancer is curable if just you get screened. When in reality it doesn’t always detect the cancer, and some cancers are so aggressive they are likely fatal even if caught very small. There’s still value in screening, but it is far from a guarantee against dying of breast cancer.

Anonymous wrote:

Anonymous wrote:Another reason this is possible is that routine mammograms don't always catch Invasive Lobular Carcinoma (ILC), which makes up 10% of breast cancers and is difficult to find because it doesn't grow as a clump but instead as a spiderweb. I had years of clean mammograms until I didn't and an ultrasound found Stage 2 ILC. My doctor said it likely had been there for over five years and would not have been picked up on a routine mammogram. A 3D mammogram showed more but it was ultimately the ultrasound and MRI that truly identified it. I think people think that all BC shows the same way -- as a tumor or clump of cells -- but that's not true and ILC doesn't get the attention it deserves for its stealthiness.

op - so should we all be getting 3d mammos? an ultrasounds?
how could someone go from NED to stage 4 in SIX MONTHS?!

PP again. I would ALWAYS ask for 3D mammos. I think they are standard now, but when I had cancer they were not; you had to pay extra (which I happily did when the ultrasound showed something unusual). I don't think they will do ultrasounds generally, unless there is something to investigate further.

NED to Stage IV in six months indicates a very aggressive cancer...OR, in some cases, it means that the cancer wasn't originally found on the mammos but some other thing led to a Stage IV diagnostic (like liver issues or broken bones) and there was a clear mammo six months ago.

I am not Stage IV myself (as far as I know).

Anonymous wrote:op - i dont believe i have dense breasts (no one has ever mentioned this).
should i be thinking about extra screening?

If you have dense breasts, it is now required that you be informed - if your mammo was clear but you have dense breasts it will be mentioned in the letter you receive with the results.

Unfortunately, the law doesn't require radiologists to tell you the implication of having dense breasts. For years, I received a letter from WRA informing me that my mammo was clear but that I had dense breasts. If the letter had said, "your mammo was clear but you have dense breasts and the sensitivity of mammography may be as low as 30%.". I might have thought quite differently about, for example, doing monthly breast exams and bringing new lumps ip more quickly and getting re-screened more quickly.

Anonymous wrote:Another reason this is possible is that routine mammograms don't always catch Invasive Lobular Carcinoma (ILC), which makes up 10% of breast cancers and is difficult to find because it doesn't grow as a clump but instead as a spiderweb. I had years of clean mammograms until I didn't and an ultrasound found Stage 2 ILC. My doctor said it likely had been there for over five years and would not have been picked up on a routine mammogram. A 3D mammogram showed more but it was ultimately the ultrasound and MRI that truly identified it. I think people think that all BC shows the same way -- as a tumor or clump of cells -- but that's not true and ILC doesn't get the attention it deserves for its stealthiness.

op - so should we all be getting 3d mammos? an ultrasounds?
how could someone go from NED to stage 4 in SIX MONTHS?!

Another reason this is possible is that routine mammograms don't always catch Invasive Lobular Carcinoma (ILC), which makes up 10% of breast cancers and is difficult to find because it doesn't grow as a clump but instead as a spiderweb. I had years of clean mammograms until I didn't and an ultrasound found Stage 2 ILC. My doctor said it likely had been there for over five years and would not have been picked up on a routine mammogram. A 3D mammogram showed more but it was ultimately the ultrasound and MRI that truly identified it. I think people think that all BC shows the same way -- as a tumor or clump of cells -- but that's not true and ILC doesn't get the attention it deserves for its stealthiness.

Absolutely, unfortunately. A best friend of my mom's just hit her 10 years clear, until 6 months later during her yearly "routine" mammogram she has a bad stage 4 diagnosis. Multiple tumors. She literally had a clean CT scan 6 months prior. F cancer!

Anonymous wrote:op - i dont believe i have dense breasts (no one has ever mentioned this).
should i be thinking about extra screening?

If you have dense breasts they let you know, believe me. I had to have my first mammo at age 29 and my breasts were small and dense. The radiologist was acting like it was my fault. He said I had absolutely no fat, all dense tissue. They become less dense with age. Mine are no longer considered dense.

It’s possible but unlikely. Unfortunately, you can’t eliminate all risk. Annual mammography reduces the risk of dying from breast cancer by 50%.

Anonymous wrote:

Anonymous wrote:op - i dont believe i have dense breasts (no one has ever mentioned this).
should i be thinking about extra screening?

Talk your mammogram reports over with your doctor. Or look at them yourself and see if you have dense breasts.

I tried to get my doctor to give me a mammo plus ultrasound and she wouldn't even though I have a bad family history. She said since I didn't have dense breasts I didn't qualify. She was very adamant about it.

Fire your doctor. Never forget that these are professionals you hire, and pay to provide a service. If they're not listening, go somewhere that will.

Anonymous wrote:

This is your PSA - if you have dense breasts talk with your doctor about additional screening by MEI and/or ultrasound. If you live in MD, Gov. Wes Moore just signed legislation forcing insurance companies to cover these additional diagnostic and screening exams for breast cancer for free (no copay).
https://www.radnet.com/about-radnet/news/maryland-legislation-diagnostic-imaging

This would be great. I have dense tissue and had an MRI. It cost almost 2K with my high deductible insurance. That's really unacceptable. It should be in the same category as colonoscopies and mammograms (preventative screening).

Anonymous wrote:op - i dont believe i have dense breasts (no one has ever mentioned this).
should i be thinking about extra screening?

Talk your mammogram reports over with your doctor. Or look at them yourself and see if you have dense breasts.

I tried to get my doctor to give me a mammo plus ultrasound and she wouldn't even though I have a bad family history. She said since I didn't have dense breasts I didn't qualify. She was very adamant about it.

op - i dont believe i have dense breasts (no one has ever mentioned this).
should i be thinking about extra screening?

Yes. Mammograms are not that effective for women with dense breasts. https://www.yalemedicine.org/conditions/dense-breasts#

"With conventional mammography, while we can be as accurate as 98% in a fatty breast, our sensitivity can drop to as low as 30% in women with extremely dense breasts, which is why supplementary screening with ultrasound or MRI—depending on the patient’s personal risk factors—can be such an important aid in finding breast cancer,”

The supplementary screening with MRI and Ultrasound is generally not paid for as part of free preventative screening. Doctors also generally don't recommend it for all dense-breasted women - just those with symptoms and/or a strong family history of breast cancer.

My gynecologist missed my breast lump. 2 mammograms missed my breast lump. Only because I had a palpable lump did I get an Ultrasound, which missed other lumps in my breast (technician didn't even check the rest of my breast).

An MRI found original lump, another lump and a large "area of suspicion" and I had more biopsies.

Ultimately, one biopsy showed invasive cancer. I was very lucky to have caught it early but that only happened because I felt a lump. And, the full extent was only known because I decided on MX. Only after the MX did the pathology show the extensive DCIS which the mammogram never saw at all and which the MRI only labelled as an "area of enhancement". One area of DCIS was unseen on any radiology. The invasive cancer was seen on MRI.

So, yes, mammograms can miss cancer, particularly in women with dense breasts. I only caught it because I had done a fingertip palpation of my breast (flat hand sweeps of breast by me and doctor missed the lumps).

This is your PSA - if you have dense breasts talk with your doctor about additional screening by MEI and/or ultrasound. If you live in MD, Gov. Wes Moore just signed legislation forcing insurance companies to cover these additional diagnostic and screening exams for breast cancer for free (no copay).
https://www.radnet.com/about-radnet/news/maryland-legislation-diagnostic-imaging

No idea who she is but I think this is possible, sadly. It usually means a more aggressive cancer. My sister was DX'd with stage 4 after missing one mammo. So essentially two years, I guess.

Just reading about Sara Sidner.
Is it really possible to go from one clear mammo one year to stage 3 the next?
That is terrifying. Should we be having them every 6 mos?