Aug 9, 2011

Boobies: To squeeze or not to squeeze

Yes, this post will be about boobies. Also known as tits. Mugs. Jugs. Bazongas. Melons. Breasts. Breasts and the big squeeze. Also known as getting a mammogram.

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.

6 comments:

gekko said...

I go every two years. It doesn't hurt me -- which surprised me since my breasts are sensitive and not very small. But I'm one of the lucky ones since it doesn't hurt.

Do the self exams, too, and all manner of guys, I'm sure, would be willing to help me with that but I usually just do it myself.

alice said...

I'm large-breasted and have fibrocystic breasts, so I've been getting mammograms for almost 10 years now. The most recent time I went, I was shocked at how painless the procedure was -- to the point where I commented to the technician. She told me that the new machines are way more sensitive than the old ones, so they don't have to squeeze as much as they used to. And then she showed me the new pictures, with an old picture to demonstrate the contrast -- and the difference was shocking! The amount of detail is incredible, plus, now they're in color (whatever that means)!

I've also had breast ultrasounds, after mammograms that were inconclusive. Those are painless and quick procedures that are almost sleep-through-able.

I don't know if the screenings are crucial, but I do like the feeling of getting that "all clear" letter in the mail every year after having a mammogram. I still do self-exams, but the back up reassurance is a good feeling. Breast cancer may not be common, but I've known more than a few people whose metastatic cancers have started in the breast, so I'm firmly in the better-safe-than-sorry camp.

Paula said...

I was stuck in the system early because of my boobworm -- a puffy vein caused by wearing a push-up bra. I freaked when I felt it, ack, worm! The doctor was a bit puzzled herself, though pretty certain it wasn't a worm. So I had my first mammo around age 35 or whenever, which also revealed cysts, and then of course too late, had to go back every year bla de bla. I have "dense breasts," or so they tell me, thus necessitating an ultrasound every time as well (to make sure all is seen). When a cyst gets large enough, or hurts, they get rid of it. So, it's all good, ugh. Oh, and I'm smallish, but the mammo hurts a bunch anyway. But whatev, I'm used to pain.

(The worm went away from Advil and coldpacks. And no more push-ups!)

Paula said...

PS: I agree with your reasoning, Keera. From what I've read last few years, I wouldn't jump into the mammo system if my risk factors were low.

Badaunt said...

I read the same study, and breathed a sigh of relief. I'm totally with you on this.

I've had ONE mammo, which is all I want to have. But I'd found a lump - a BIG lump, which turned out to be a harmless cyst. Several of them, actually.

When I went back a couple of years later to get one painful cyst removed the doctor (Japan's top breast cancer specialist! My GP knows all the right people) didn't suggest a mammo, just did the aspiration of the cyst, using ultrasound. I didn't say anything because I didn't want to go through that again.

The next time I went back for a regular (semi-regular, really) checkup he did the ultrasound first, then told me the mammo wasn't necessary because the ultrasound was thorough. I wonder if he'd read an early version of the study?

(My mammo was painful because of the cysts and because of the timing - just before my period. But I don't think they are ever exactly comfortable.)

Keera Ann Fox said...

Thanks for all the feedback, ladies! I'm happy I blogged about this. I've already learned from all of you!

I see that I need to make sure all my information is up to date, whenever I have a health decision to make, and keep my eyes out for developments in this field.