In Norway, all woman are automatically offered bi-annual mammography examinations between the ages 50 and 69. Just before Easter this year, I got the letter informing me of my first appointment, accompanied by a questionnaire and a brochure, all delicately done in pleasant shades of pale green (now long recycled).
Every time I see the picture of a well-endowed woman (they always seem to have pendulous, D-cup boobies), topless, standing next to a large piece of machinery, with one breast flattened between two plates of glass, I cringe. I cringe mightily.
Breasts are sensitive and don’t like rough handling, and it hurts like hell to get them squeezed. So I’ve read about breast cancer and mammography and I’ve also read about alternative technologies of spotting growths in mammaries, like shining a light through like when you hold a flashlight up to your fingers, and I tell myself that I can wait until technology improves to the point that I can get screened for tumors with a flashlight rather than the big squeeze. Because the squeeze ranges from very uncomfortable to tear-producing painful and I don’t know which will be my experience.
So after reading the whole brochure, and googling risk factors for breast cancer (I have a few as do we all) and thinking about what would be the prudent move for my overall long-term health, I cancelled my mammography appointment using the e-mail address provided for that use. They accepted my cancellation without question. I figure they can always ask me back again in two years. I’m more concerned about cardiovascular disease, anyway, since that’s what kills most women.
The thing is, nobody knows for sure what causes breast cancer. Many risk factors given are actually based on good guesses, some of which come from experience with other types of cancer. The only sure-fired correlation is that as westerners have gotten fatter and more prone to diabetes, the rate of breast cancer has gone up. And that may not be just a correlation (see below).
What prompted me to write about this now is a report that came out recently, showing that screening does not reduce mortality from breast cancer. This page (in Norwegian) has a graph comparing Norway to Sweden. By comparing two similar countries that started screening a decade apart, it is easier to see if screening has any influence on breast cancer mortality. It doesn’t. The slightly lowered rates seen in the graph are due to improved treatment.
Norwegian researchers are now going to reevaluate the mammography program. The belief was, when it was started, that screening would reduce breast cancer mortality by 30%; the result so far is only 10%. There are those who say mammograms are still helpful, but others point out that if the number of false positives are added to the figures, that 10% improvement may be even lower.
One thing to keep in mind is that self-examination is still the best way to detect changes in the breasts between screenings, and many women discover tumors on their own, not in a radiologist’s office.
Another thing to keep in mind is that new discoveries are constantly being made—and in some cases, old discoveries are brought to light again. I just read an article that said sugar causes cancer. It’s not sugar itself, actually; it’s insulin. Insulin is a type of growth hormone and that can promote cancer cell growth. (See "Sugar and Cancer: Is There a Connection?") Which is why the correlation may actually be causation.
So I choose to wait. I wait for the research. I wait for the technology. I wait for something better than two glass plates for my two tits.