Why I Hate the New Mammogram Guidelines

Twenty years ago, the writer, then 34, had a mammogram she feels saved her life.

Quick. Think back to what you were doing on a specific day 20 years ago. Or what you were wearing. Or even what the weather was like or what you had for dinner that night. Chances are you can’t. (I’m challenged by even trying to remember what I did yesterday.)

 But that day 20 years ago, I remember as clearly as my children’s birth. I wore a blue sweater with a white t-shirt underneath. The sweater had a pull on its left sleeve from where my son’s toy caught on it earlier that day when I picked him up to kiss him goodbye. It was cotton and had a v-neck; from the Gap. The day was unusually balmy for mid-November – around 70 degrees, I think. On my feet were white tennis sneakers but if I didn’t know better, I’d say I was wearing lead boots. And my dinner? All I could manage to swallow was a few spoonfuls of cookie dough ice cream, somewhere around 10:00 PM after I reluctantly tucked my two little boys in and kissed them goodnight, inhaling their leftover energy to help get me through the long night. 

Twenty years ago I had my first-ever baseline screening mammogram. I exited the radiologist’s office in a daze, the office that looked so much uglier than when I entered. I left enveloped in fear and disbelief. I had gone for the mammogram alone, thinking there was no reason to drag my husband or a friend along with me for what would be a quick and routine test. I shuffled out of the office robot-like, stifling my sobs, searching for my lost car in the darkness of the unfamiliar parking lot. I couldn’t stop shivering, although I knew damn well it wasn’t cold out.

The radiologist left me with this news: my mammogram showed some suspicious calcifications and I needed to schedule a biopsy as soon as possible. Diagnosed as intraductal carcinoma, the cancer came seemingly out of nowhere and permanently landed me in an emotionally-altered place. A modified radical mastectomy followed by four rounds of potent chemotherapy drugs and five years of tamoxifen came next. My hair would grow back, as would the weight lost by the stress and nausea….but what was new was my deep appreciation for the availability of the screening device that had saved my life.

That mammogram happened when I was 34 years old.

Why did I get a mammogram when I had none of the risk factors for breast cancer? I don’t really know for sure. But I had visited a surgeon a few times for various lumps that cropped up on my young, dense breasts, and although he did not think the latest lump was suspicious, he casually suggested I “get a baseline mammogram. After all, you’re almost 35; may as well.” I don’t remember if the age for a baseline 20 years ago was 35, but no matter. Maybe he was just being overly cautious; perhaps he didn’t trust himself to discriminate between all the different types and feels of the lumps. One thing I’m sure of is this: had he not suggested it, I would not have gone for the mammogram. And I probably wouldn’t be writing this today.

Yesterday’s news on new mammogram recommendations made me scream. You might have heard me from where you were. How in the world can the task force of supposedly “expert” “brilliant” “influential” scientists even consider moving the age of screening 10 whole years, from 40 to 50? They say that mammography at 40 to 49 saves lives – but just not enough of them. What about the thousands of lives – like mine – that they DID save?

I wonder if any of these "experts" have/had wives, daughters or any other loved one – even themselves – who were diagnosed with cancer younger than 50. If they had, I can’t imagine that they’d ever, in all good conscience, stand by these recommendations. I wonder if any of them even know that, though the number of young women with breast cancer accounts for a small percentage of cases, there are more than 250,00 women living in the U.S. who were diagnosed with the disease at the age of 40 or younger. Or that approximately 10,000 young women will be diagnosed in the next year – or even that breast cancer is the leading cause of death in women ages 15-54? And they’re all somebody’s mother, sister, aunt, wife, friend.

I urge anyone endorsing or thinking of implementing these new recommendations to think of themselves as fathers, mothers, sisters, friends of someone with an undiagnosed breast tumor festering unknown because they were denied the only useful diagnostic tool we have. I urge them to ignore the statistics they cite that you’d have to test 1900 women to detect one with breast cancer.

Ask any woman and I’m sure she’ll tell you the same thing: that she’d rather go through the “anxiety” and “inconvenience” of an unnecessary biopsy than live with the knowledge that there is something out there that can potentially save her life that she cannot have access to because of the inconsequential “numbers.” I’ll bet she’d rather be “overtreated” than be left in the dark.

And another message I have: until there are more answers than questions, please stop studying the numbers and study the people like me and thousands others, instead.

First Published Wed, 2009-11-18 11:16

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