To Boob Or Not To Boob

Many women are confused with the recent changes regarding age recommendations for mammograms. The guidelines have changed with frequency over the years.  Because there is a wealth of information generated through studies and how it is disseminated to the public, it can sometimes be hard to keep up with the latest research and assess where you fall into the mix of things.

When I went to my first social function after being diagnosed with breast cancer, I was amazed at the wide array of information that was floating around the room.  Of course, everyone wanted to know my story. How did you figure it out, what were your symptoms, what’s your family history, had you ever had a mammogram before?  Their responses ended up being just as thought provoking as my answers.

As I began to share my story, I can see the overwhelming wave of confusion settle over my peers’ faces…the mean age in the room was the same as mine.  I had discovered my cancer through my first mammogram at age 38.  After having a mastitis, my doctor recommended a mammogram and ultrasound to make sure there wasn’t anymore underlying infection in my breast.  It would be a good opportunity for a baseline too.  I remember thinking, “If it was relevant to get a baseline in the first place, why wasn’t it mentioned when I was 35”?

Leaving the doctor’s office, I began to remember the time when I was breast-feeding at age 35 and recalling the thought to get a baseline mammogram once the baby was weaned.  Hearing all the past horror stories involving women’s experiences with mammograms, I was not too eager to bring the subject up.  My doctor didn’t bring it up either.  But here I am 3 years later, getting a baseline mammogram anyway.

As I began to recount my story, the first woman chimes in “My doctor doesn’t believe in baseline mammograms, it leads to too many false positives”.  Another mentions that her OB/GYN recommends baseline mammograms at 35 but a lot of times insurance companies won’t cover it.  In the midst of the confusion, a third one says that she thought mammograms weren’t recommended until you were 40 years of age.  “That’s if there isn’t any prior family history, another responds.  If you have family history, you start having mammograms at an earlier age-even 30 years old”.

I was struck by how different and far apart everyone’s information gathering had taken them.  These were all well educated, intelligent, Google-savvy women.  Where does the breakdown in communication lie? If cancer doctors and organizations can’t even agree on what is the right age for a woman’s first mammogram, how could my peers know?

While the American Cancer Society and other cancer organizations still recommend mammograms yearly after the age of 40, the U.S. Preventative Services Task Force states that with no prior history, women do not have to start having mammograms until the age of 50 and to repeat the test every two years thereafter.  Studies show that despite more women being diagnosed with early stage breast cancer due to earlier screenings, the number of advanced breast cancer cases has not decreased. Advocates of the Task Force’s recommendations also claim that the risk of women between the ages of 40-50 is so small that it doesn’t warrant the exposure to the radiation.

Unfortunately, I am one of those women who while diagnosed at a young age, had no notable family history at the time of diagnosis and had a very run-of-the-mill type cancer.  The woman that you don’t hear too much about due to the overshadowing of young women who have more aggressive cancer that can sometimes be attributed to genetics and do have familial history of the disease.  Those women who are aware of the risk even at young age and know they should be getting mammograms earlier rather than later.

Aside from my diagnosis, I also know several women between the age of 40-50 who all had no family history and non-aggressive breast cancer.  If I know this many people already, how many other women are out there who fit this same profile? Women who will wait 10 years to get their first mammograms, many who will be perfectly fine, but some who will not.

There is so much miscommunication on the pro’s and cons of mammograms.  I would employ anyone who is concerned about waiting longer to get a mammogram to have a dialogue with your doctor.  There may be options and information that you are not aware of that may consequently lead to better decision-making regarding your age appropriate imaging needs.

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