Keep Your Cameras Out Of My Cleavage

meowser-48.jpg posted by meowser

I’ve got a doctor’s appointment on Tuesday. Once a year they make me get a Pap smear so I can keep getting my Kariva (generic Mircette), without which I am a heaping pile of truly debilitating crampage that makes me feel like I’m passing a bowling ball every three weeks, not to mention suicidal PMS and more zits than a gymnasium full of eighth graders. The Pap is no problem. I’m lucky to have a doctor who doesn’t sing me tortured multioctave arias about my weight; he knows I have PCOS and am on antidepressants and there’s not much I can do about either. But he does make a big deal of the fact that I haven’t had a mammogram yet. And now I’m 45. I’m supposed to have had five of them by now. Five.

I have all kinds of reasons for not wanting to get one, besides the default reason of being too lazy. There’s maybe one week a month where I don’t have any breast tenderness at all, and you know, I’m aspie. If the procedure hurts, I am likely to have a meltdown. (I went through hell on an x-ray table a few months ago, when the incompetent tech had me lie on the side where I was already having excruciating pain and kept asking me to “scoot down” not caring that I was already in agony, and took the same x-ray FOUR times because she kept messing it up. Oh, yes, I melted, I melted.)

I do have a stash of Klonopin I can use to stave off meltdown if need be, but I rarely take it because it’s incredibly sedating and staying awake is enough of a problem for me. But maybe I want to be asleep for something like this? I remember Vesta44 saying recently that when she had a mammo, they had to take four separate pictures because of the size of her breasts, and they’ll probably have to do likewise with me. Eef.

But even that’s not the biggest reason I don’t want a mammogram. The biggest reason is that I’m scared to death of what they’ll find, and whether it’s really what they think it is. And according to Sandy’s post on Junkfood Science this week about mammograms, it looks like my worries have some basis in reality. Sandy cites this study published in the British Medical Journal (no, really, read it, your eyes will bug out of your head) that was conducted by a Norwegian research team, in which almost two million breast screenings were examined in multiple countries, and the sentence that leapt out at me was this:

The rate of false positive diagnosis after 10 screenings was 50% in the United States and 20% in Norway.

Okay. First of all, I want to know why they’re doing a better job of eliminating false positives in other countries than in this one. Aren’t we all theoretically using the same equipment? Is there something about American breasts (and yeah, I keep thinking of “Two Wild and Crazy Guys” too, it’s not just you) that makes it harder to screen them? Or are the techs not receiving adequate training? In any case, that brings me to my second point: Fifty percent? Are they fucking shitting me?

All the “FAT PEOPLE ARE COSTING ME PRECIOUS HEALTHCARE DOLLARS BLAAAAARGH” people need to feast their orbs on this particular stat, because this is what’s opera, doc. EVERY woman in America is expected to get a mammogram EVERY SINGLE YEAR from age 40 onward. For an average woman’s lifespan, that could be 40 mammograms. The cost of the screening itself isn’t much, but do you know what happens when they find something? They send you for more tests, and then you have to have a biopsy. All that ain’t cheap. Not only that, the elapsed time between mammogram finding and biopsy results probably engenders some of the worst psychological torment a woman can possibly experience. Am I doomed? Or will I be fine once I go through a couple months’ worth of surgery, chemo and radiation, possibly repeated multiple times over the next few years, assuming I can even spare the money to take the time off and pay all the damn medical bills? Death or generalized weakness and vomiting and pain pain pain PAIN plus losing at least one boob and figuring out whether I can afford to replace it/them surgically and whether I really want to do that anyway? Or is it really nothing and I’m being a big mustard-dripping Oscar Mayer weenie about the whole thing?

I don’t know if there’s enough Klonopin on earth for this.

Oh, and as if that wasn’t enough of a barrel of red plastic lead-infested monkeys, there’s also the fact that a lot of those real positives are NOT invasive cancers, but are largely treated as such, with women having to go through the same surgical, radiological and chemical wringer as for more aggressive forms of cancer. I’m not sure what gives them the idea that surgery, radiation and chemo are harmless for people who don’t critically need them, but shit, they’re not even harmless for people who do critically need them. They don’t make men go through all that for every case of prostate cancer; why is every case of breast cancer treated like some four-alarm fire, regardless of the type? (And talk about needless health care costs, yikes.)

And that’s not even getting into the mucky pool of false negatives. Sandy also did another breast cancer piece a few months ago, in which she cited the findings of British breast cancer treatment pioneer Dr. Michael Baum:

Screening takes place [in Britain] every three years, so it doesn’t tend to catch the fast-growing, aggressive cancers, such as high-grade invasive duct carcinoma and inflammatory breast cancer.

Furthermore, only one in 1,000 women will avoid death from breast cancer over ten years of attending screening.

Maybe I need a bottle of scotch with that Klonopin. Or maybe hash brownies would pose less of an interaction risk, I don’t know.

(If you want something from an American source, Sandy also references the cancer.gov page on breast cancer‘s statement on false negatives: “One in 5 cancers may be missed by mammography.” And these are people who are pro-mammogram.)

I do self-exams every month. Multiple times a month. Always have. But really, talk about gambling with your time and psychic energy. I could be in that 0.1% of women whose life would be saved by a mammo. Anyone could. Breast cancer does not have a strong genetic link; the fact that it’s unprecedented in my family means nothing. (And how do I know that one of my pre-mammogram ancestors didn’t have one of the noninvasive forms of cancer that never caused her any trouble, and so never even knew it was there?) On the other hand, there’s also no consensus that premenopausal breast cancer is any more common in fat women than thin women; in fact, some experts think fat women get it less often. (That link has other interesting factoids in it, like the finding that tall women — 5’9″ and up — are more prone to breast cancer than shorter women. Though I’m not sure how you’re supposed to “maintain a body weight that is neither too thin nor too fat” any better than you are supposed to make sure you don’t grow to be “too tall.”)

But getting the mammo is chancy regardless. Do I really want to know what it says? Not to mention the fact that once you’re diagnosed with cancer, your “healthy fatty” privilege goes out the window. If a thin woman gets breast cancer, it’s random bad luck; if a fat woman gets it, it’s because she’s a self-destructive oinker. But really, if it weren’t for the ridiculously high inaccuracy rate, I’d probably go anyway. If I have to be put through the wringer because I’m truly ill, so be it, but the prospect of going through the wringer for nothing is what gets me. Not to mention the fact that women are relentlessly pressured to do so. Year after year between 40 and death. How long can I hold out?

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36 Responses to “Keep Your Cameras Out Of My Cleavage”

  1. Lindsay Says:

    I’m barely 18 and I’m already scared of this mammogram nonsense. I’ve never once heard that a mammogram saved a woman’s life (though I’m sure it’s happened), only that even women who get regular mammograms miss the rapid forms of cancer… because hey, what are the chances they happen to get the mammogram right around that time?

    Aside from all that, jeez, what you went through was just unnecessary. I think pretty much everyone can relate to this post. Like me – a few years ago I busted my knee and went in for an X-ray. When I asked why the tech did the wrong knee, she yelled at me, despite the fact that I was a scared kid that had no idea what was going on. I told her I assumed they needed a comparison, how could I know the procedure? She actually refused to X-ray the injured knee.

    But, you know… in the end, I’m fat, and it’s always possible that the fat seeped into my brain and I got the stupid all up in me. Always a real concern.

    Anyhoodle. Totally relevant, awesome post. Thanks for taking the time to write it.

  2. lilacsigil Says:

    Mammograms are not recommended until 50 in Australia, and then every two years. Most fast growing cancers are thought to be detected by examination, not by mammogram.

    After 18 months of not having my thyroid cancer diagnosed (major symptoms: extreme weight gain, fatigue) because I was “fat and lazy”, I know that you can rarely rely on the medical system to make the right choices. Life is risk. If there’s nothing wrong with you by your own examination, make your informed choice and live by that. Personally, I would rather have the scans and rule out further cancers by as many means possible, but I don’t have to juggle insurance companies and the American health system. I wonder if the rate of false positives in the US is due to techs keeping lawsuits in mind?

  3. angrygrayrainbows Says:

    Woah… interesting post there, Meowser. I had no idea about the rate of false positives… or false negatives.

    Reading your post, one thing came to my mind… that it’s better to do a thing than to live in fear of the thing. At least, this is what is true for me, especially in terms of medical stuff. I hate docs. I have had really bad experiences with them since I was a kid and it is like pulling teeth to get myself to go to the doc even when I KNOW I need to. But, I’ve found I feel a whole lot better just doing whatever it is than spending days/weeks/months/years going in circles about whether I should or shouldn’t and all the guilt and frustration and all that.
    The nice bit is that knowing these stats about breast cancer and mammograms arms you with facts that are really helpful. I know I’ll never forget them…
    Anyhoo… maybe my not liking to live in fear of a thing mind-set isn’t your cup of tea. If so, fair enough.
    I know when I’m 40 and this mammogram stuff comes up that I’m am so not going to want to do it. Meh… but, my hope is that I will do it anyway. I know me and the worrying and feelings of neglect for not taking care of myself (by not getting tested) just aren’t worth it.

  4. Patsy Nevins Says:

    I will be 60 in September & I have never had a mammogram. I never will have a mammogram. I never wanted to anyway & reading about it just confirms what I believed, that they are painful & virtually useless. I am very anti-medical community anyway & do not go near medical people unless I cannot avoid it, such as when I fell in the bathroom last May & cut my ear half off on the bathroom wall. I don’t like them, I don’t trust them, & I think that they are very often misinformed themselves, especially about fat women & health. My grandmother & mother never had mammograms, nor indeed did many millions of women for many generations. Mother & Nana lived to be 85 & 90 respectively, with no sign of breast cancer, nor has there been any among any of my other female relatives. I also have spent nearly three years of my life breastfeeding, for whatever good that may do, have always been a regular exerciser, & do not drink or smoke, etc. Everyone has to make her own choice, but I really hope that Sandy’s post helps us understand that it IS a choice & one which may not save our lives & may cause unnecessary suffering. My choice is not to have mammograms.

  5. liz Says:

    I just had my third one and it was really not bad in terms of squashiness. The bigger you are, apparently, the less it tends to hurt. However, they do need to take extra pix when you’re larger (I am Ginormous in that arena, and so they took many many).
    However, I am not advocating you get one if you’d rather not. More important to get regular dental check-ups!

  6. wellroundedtype2 Says:

    I had a mamogram (and an ultrasound) for something lumpy I felt.
    I was expecting it to hurt, and it didn’t.
    I got the results rather quickly (the lumpy thing had already begun to feel different by then) that it was nothing to worry about. And now I know that the particular lumpiness I was feeling was normal for me.

    One option would be to get a baseline. That way, if you do notice something unusual on your own, there will be a point of comparison. I’ve seen guidelines that recommend every 1-3 years. Just because you get one mamogram doesn’t mean they will hunt you down and drag you in every year.

    Your thoughts about this and concerns make sense, but the question I would have is — if you weren’t worried about the pain and the accuracy, would you do it, or is it more the preferring not to know?

  7. Birdyluv Says:

    I’m in my 40’s and have had several mamograms already, including one that turned up a suspicious area that, upon ultrasound, turned out not to be. Don’t let the fear of the test stop you from having it. I didn’t find it to be painful at all, more like a squashy discomfort that lasts only a minute while they’re taking the picture. Just be sure to schedule it for about a week after your period end, if you’re prone to hormonal tenderness in the breasts.

  8. Aurora Says:

    I want to add to the comments of less hurt than expected (and I do know that the post was about way more than that!). It’s not that it’s exactly pleasant, but given the messages I had heard from popular culture, my experiences have been surprisingly painless. That doesn’t deal with other issues, like being partly naked in front of a stranger, having a tech who is insensitive/incompetent, aspie issues, or the BIG elephant in the room, the false neg and false pos rates. However, I understand most medical recs are to combine mamms with other survelliance techniques, since no one form is going to be totally accurate. I think as with all medical issues, a person has to weigh the evidence, apply it to her own situation, and make an informed decision. good luck Meowser!

  9. moxie3 Says:

    Meowser,

    With my frame of mind lately I’ve put off the pap and the mammo for about 2 years now. I bad, I’m almost 49 and my little sister was diagnosed with breast cancer about 4 years ago. She had her annual mammo but they didn’t detect it. One day she “saw” a lump in her breast and that’s when it was discovered. In her head, I don’t know if this is possible or not, she felt as if her previous mammo had caused the lump. I’m not really sure how this could have happened.

    Anyway after that I didn’t really care about mammos because they never caught her lump and I know some are fast growing. I’m going to make an appt. this spring for the annual gyno thing and get my script for the mammo. I’d rather go through the mammo than the gyno exam as it’s a new doctor and that’s always difficult. Mammos are uncomfortable for me but I basically feel like cattle depending on the person who does it. It may pinch a bit but I’ve never considered it painful.

    Anyway I still feel I should do both and if you had a false pos I think they would do it again. I know people who get false pos all the time for some reason. And get tested a second time and they’re clear. I’ve never experienced it. Anyway maybe I’m old school but I still think it’s something we need to do for ourselves and I’m going to myself, take care moxie3.

  10. Godless Heathen Says:

    My question is, if you are able to get a free mammogram and they find something, false or real positive, what happens if you can’t afford medical treatment? If you have no insurance and live on a very small income, you’ve basically just been given bad news you can’t do squat about.

    I’m more worried about MS, given how many people in my family have been affected. Not that I could afford medical treatment for that either.

  11. littlem Says:

    One option would be to get a baseline. That way, if you do notice something unusual on your own, there will be a point of comparison. I’ve seen guidelines that recommend every 1-3 years. Just because you get one mamogram doesn’t mean they will hunt you down and drag you in every year.

    That.

    I too fear the false positive with many fibers of the being. I cope with as much water and garlic, booze only at Easter and Christmas, and as many workouts as I can handle to clean out the lymph system, and about half the recommended number of mammos post-baseline. After all, excess stress is supposed to contribute to the cancer rate, so if you keep your stress down by limiting cameras down the cleavage, you’re doing your part, right?

  12. JeanC Says:

    I’ve been getting mammograms yearly for a few years now (in fact just had one this last Monday) and look at it as just another tool in my health tool box. Do I like them, not particularly, as much as I loath doctors and what not, but I have had grandparents all die of cancer of some form or other and I will use every tool in the book to make sure I don’t get blindsided.

    Do I rely on mammograms? Nope, most breast problems are usually discovered with other means and between hubby and I, the girls are well checked out on a very regular basis 😉

    One thing that really helps is to have an imaging center that is staffed by well-trained, professional and caring people. The one I go to here is and I am very appreciative.

  13. meowser Says:

    Lindsay: OUCH.

    Lilacsgil: Ooh, interesting point that they could be calibrating the machines differently here to pick up more stuff…and yeah, avoiding malpractice suits, I hadn’t thought of that.

    AngryGray Rainbows: Yeah, that’s kind of why I can’t just say, “Absolutely not, I’m never getting one.”

    PatsyNevins: I don’t blame you a bit. But as far as this type of cancer goes, it really does not seem to discriminate all that much as to who gets it and who doesn’t. I had a neighbor once who was as much of a health nut as you can imagine, and was always thin, and she got it. Nulliparous women get it, women who have kids young get it, women who have kids not-young get it, women who smoke get it, women who have never smoked get it, women who used to smoke get it, women who bottle-feed get it, women who breast-feed get it, women with family history of cancer get it, women without family history get it…it’s pretty random, really. It’s not like lung cancer, which is so strongly tied to pulmotoxins like cigarette smoke and asbestos, or ovarian or colon cancer, which are very strongly tied to genetics.

    Liz, Birdyluv, Aurora, Jean C: Thanks!

    WRT2, that’s not a bad idea. And yes, it’s definitely the inaccuracy rate that scares me away the most.

    Moxie3: My condolences to your sister. But mammograms causing malignant tumors? I don’t see how. I suppose it is possible, though, that there was some soft tissue damage caused by the exam that made the malignancy more obvious, and the malignancy was one of the 1 in 5 not picked up by mammograms.

    Godless Heathen: No kidding! I know I’m subject to a $1000 deductible on lab tests, so I don’t like to get them just for shits and giggles. But yeah, the expense of the whole biopsy thing is an issue, too; lots of women don’t have coverage worth squat when it comes to that.

    Littlem: BWAH! Although I’m not sure stress is a cofactor in cancer as much as it is in things like cardiac and vascular disease and endocrine problems like diabetes, which are greatly influenced by cortisol. Less stress is always good, though. (And “water and garlic”? Simultaneously, or separately? My aspie brain is picturing swallowing a clove of garlic like a pill.)

  14. buttercup Says:

    I have issues with doctors and have not had a mammogram yet-I’m 48. I self-exam and don’t have any particular risk factors. Haven’t had a pap smear since the 80s, either. I have serious issues with gynies. I don’t think I’ll ever be able to suck it up and go unless I think there’s something wrong.

    Cancer medicine is very scary, especially in places where there is a high percentage of medical schools, like here. I still maintain that the aggressive treatment my best friend’s non-malignant brain tumor got eventually turned it malignant, and the chemotherapy had more to do with her getting seizures than the tumor did, and her eventual death was caused by years of treatment, not by cancer. I could be wrong about some, all, or none of the above, but I’m staying far away from any of that sort of thing for as long as possible. I get meltdowny about it myself.

    IMO it comes down to your body, your choice what diagnostics to run on it. Nobody can force you to get tests you don’t want.

  15. wellroundedmama Says:

    Meowser, you’re psychic. I’m doing the should-I-or-shouldn’t-I dance right now. I’m “overdue” for a mammogram by several years and have been beating myself up about it, but honestly I hate them. I’ve been planning to do it sometime this year but have been procrastinating it in a major way.

    On the don’t-do-it side, I find mammograms painful….not unendurable-painful but definitely not comfortable, and being a pain-wuss, I’m not eager to go do it as a result. Also, having a Rack of Doom, find that the techs often aren’t very sensitive about how they deal with well-endowed women. I had a BAD experience with this years ago and it’s made me hesitant ever since, even though I’ve had better treatment in mammograms since then. I’m reluctant to sign up willingly for the chance for such humiliation again.

    Plus I have fibrocystic breasts (very lumpy) and have already been through a number of unneeded mammograms as a result. Seems to me like the possibility of false-positives are higher for me, and that gives me real pause. I’ve seen family members suffer from over- or poor-treatment of cancer so the idea of getting a false-positive and going through the wringer for nothing is very scary and real to me.

    OTOH, I have a cousin (unrelated genetically, but still) who is dealing with aggressive breast cancer right now, and she’s only a few years older than me. Her prognosis is not good; they’ve found 2 cancers in the space of a year. The specter of leaving my children motherless is very powerful, and a strong motivator to consider a mammogram because if it’s caught early, many forms are reasonably treatable. If I can do anything to lessen that chance of leaving my children motherless, it seems reasonable to really consider it.

    But I was shocked at Sandy’s piece on how many false-positives there are and how little influence mammograms have on actual endpoints like preventing deaths. That really gives me pause.

    So now I’m even more confused than before. I have no idea what I’m going to do. But I thank you for blogging about it and opening up a dialogue on it. Glad to know I’m not the only one thinking these thoughts out there. Let’s keep talking about it.

  16. Sandy Says:

    I hope it’s okay to post here. What may be hard for all of us women to wrap our brains around is that for most of us (clearly if you have a rare genetic thing, no universal preventive guideline applies to you), if we just didn’t worry and went to the doctor should we develop actual symptoms, then our outcomes would be the very same as if we’d worried, were screened endlessly, and had every little lump treated (that may or may not have ever amounted to anything). I have also been surprised at what the actual evidence continues to show and show. There is so much sales of tests and screenings, telling us to believe that if we catch most breast cancers early, then we’ll cure them and live longer. But that is not what the science is showing. It’s called lead time bias. [This piece may help: http://junkfoodscience.blogspot.com/2008/10/sidebar-understanding-screening-tests.html%5D
    In other words, if any of us (heaven forbid) actually get an invasive form of cancer and it’s picked up early, then we just spend that many more years being a cancer patient and scared out of our minds and enduring cancer treatments, only to die at the same time as if we’d lived our lives to the fullest and sought treatment when the symptoms appeared. It’s a humbling realization that we may have been so misled all of these years and that our own fears are being so manipulated and taken advantage of.
    The other side of the coin is even scarier: that ten times the number of women who are perfectly healthy and would never have been bothered by breast cancer, are being told they have cancer because of screening tests, and are spending the rest of their lives believing they are at risk of dying at any minute. It makes me want to cry. At the very least, we all deserve to know that screening may not be all that it’s cracked up to be. It’s icky to think that the ungodly amount of money in these tests might have anything to do with all of this. Ladies, we are made of strong stuff and deserve the objective facts to decide for ourselves, not to only get one side of the story.

  17. Meowser Says:

    Buttercup: I am so sorry about your friend. I have no idea why anyone should be subjected to chemo and radiation for a benign tumor. That just sounds completely senseless to me.

    Well-Rounded Mama: My condolences about your cousin. (And I have some follow-up questions for you I’m going to ask by email.)

    Sandy: Of course it’s okay for you to post here! Like you, I am stunned that, at least here in America, nobody dares challenge the sanctity of mammograms, or even dares question why the accuracy rate is not what it is in other countries. This is not small potatoes; this is something that is likely to affect every 40+ woman in America sooner or later; even if she’s uninsured and too broke to pay for mammograms (not to mention followup exams and treatments) out of pocket, it’s always going to be banging around the back of her head that OMG I might have cancer and don’t know it.

  18. kathleen c. dillon Says:

    i am an ultrasound technologist and have done many breast ultrasounds – as well as having had one and also having had a (thank god) negative breast biopsy.

    my recommendation, NOT THAT YOUASKED, is to get a driver, take a shit-ton of valium (i’d take 2 or 3 five-milligram tabs if it were me), and get the mammo *only so you have a baseline*. then you don’t have to think about it for several years.

    you can contact me . .. i can read mammo, i can read ultrasound, i know ALL the rules about sensitivity and specifity and fat people and thin people and old people and young people and microcalcifications and densities and spiculation and blah, blah, blah. i will totally help you online. i think you may be able to see my email above but if not, i’m kathleen and it’s bluevireo55 at yahoo dot com.

    sorry to give unsolicited advice but this would be a reasonable way to go. get sedated, relaxed, get it done (they don’t hurt me, but it’s different for everyone), get the results, and i will talk you through it. ALL MY BEST to you!

    kcd

  19. buttercup Says:

    Meowser, if I recall correctly, and this is going back12 years, it wasn’t malignant but it was a type of tumor that could possibly become malignant. There was a specific type of cell and I can’t remember the name any more but what the doctors told her was that it could “go malignant” in the future, so they treated it. The last 5 or so years of her life were a living hell and I put that down to her course of treatment.

    As to medical sanctity, its an old concept. Doctors are supposed to be treated like some kind of religious figure and we are not to question them or their rituals, including screening until they damn well find something.

    Sandy, that lead time bias is something I’ve suspected for a long time. Nice to have a name to put on it.

  20. meowser Says:

    Kathleen: Oh, thank you so much! I might just take you up on that. (And yeah, I — and only I — can see your email just fine, but thanks anyway.)

    Buttercup: Wow, that just sucks. I think lilacsgil probably had it right, though; they’re so freaked about a potential malpractice suit that they will err on the side of over-investigating and over-treating.

  21. akaEloise Says:

    I’ve had six or seven mammograms, and find it less uncomfortable than having my teeth cleaned. But YMMV. I think it is a good idea in general to have a baseline at 40 or 45, especially if your insurance covers it…without a family history you should be good for 5 years with that. Then if, God forbid, you ever find a lump, you’ll have been through the process once and know what the deal is. But in the end, you know best what stresses you out, and if you think having the mammo will do it, you should respect that feeling. Maybe you could ask if you could go to the breast imaging place and see the equipment, talk to the staff first? Like people who have fear of flying are recommended to hang out at the airport?

    My most recent mammo turned up some suspicious calcifications, so I had a second diagnostic one, and then when that still looked suspicious a stereotactic core biopsy. This was not exactly pleasant…. it involves lying absolutely still for an hour or so on an elevated table with one tit hanging through a hole while a crew of women bustle around underneath like the pit crew at Jiffy Lube. But it was not that bad, and I got a clean bill of health. And I have to say that all of the people I worked with at the breast imaging place were wonderful….very warm, very reassuring, but also giving good information.
    One of my colleagues who’s about the same age as me had the same kind of calcifications around the same time, and hers came back as cancer, so she is taking tamoxifen. She weighs about half what I do, vegetarian and extremely athletic….I think that, while not wishing me ill, she felt it was a bit unfair!

  22. Textual Fury Says:

    Hi there, first time reader. Followed a trackback here.

    I am a physically disabled 24 year old woman. Today I had to fight with the mammography people for accommodation. I had to advocate for my right to not stand during the mammo. They wanted someone to hold me up for the duration.

    The reason I am about to have a mammo is the risk of cancer, as well as to get a base line for scar tissue from noncancerous tumor like skin stuffs. An ultrasound is coming eventually but my doctor and I discussed it and the baseline Mammo will help prevent my need for non necessary surgeries, and is what the insurance will cover.

    If you decide to get a Mammo call the head of your radiology department and explain what you need. What accommodation do you require for you to safely endure this invasive procedure?

    I needed to be able to sit, and to not have a receptionist argue with me for the validity of a medical process. You might need sedation, or, to have someone else in the room with you. Consider that the ADA requires they accommodate your requests with in reason, and as long as it can be logically argued that you are being reasonable, then, you can at least feel somewhat safer during the process.

    I am afraid that it will hurt, especially since I have lesions in my flesh and they squish you. My doctor wants the baseline partly due to my size, it took an assistant for her to examine my breasts.

    Due to my condition I do weekly self exams, but with my breasts being very thick (Firm and stay up high despite being over a DDD) it is harder (supposedly) to feel for lumps.

  23. Jenny Says:

    Data point: A yearly mammogram saved my mother’s life when she was 48 years old.

  24. PortlyDyke Says:

    I’m so glad to see this post. I’ve had exactly one mammogram (the first year I was “supposed” to start getting them regularly) — and beyond the discomfort and the stats and all, it just seemed really, really stupid to attempt to “fight breast cancer” by periodically shooting x-rays through your boobs. Know what I mean?

  25. spot check billy Says:

    The mammogram certainly didn’t save my wife’s life, but the chemo and surgery afterwards may well have. Since the tumor was malignant and invasive, letting it take its course probably wouldn’t have worked out as well.

    And perhaps if my mother hadn’t waited until 55 to have her first mammogram they would have found her cancer before it got out to the lymph nodes and she would have made it past 57. Or maybe not, there’s no way to tell.

    Everyone has to make their own decision, but these tests aren’t completely useless, and the downside of not getting them can be pretty tough on the survivors for decades.

  26. Pencils Says:

    I’m overdue for a mammo–I had one scheduled last year and then found out I was pregnant, so no mammo. I’ve only ever had two–I’m 42 years old–and both times they couldn’t “read” my boobs so sent me for an ultrasound. I asked why I couldn’t just go straight for the ultrasound this time, which doesn’t hurt, and my doctor just couldn’t wrap her brain around that. There’s no way to bill my insurance for it, apparently. Siiiigh. I haven’t actually made the appointment yet, but I should, my mother-in-law died of inflammatory breast cancer two years ago and I’m terrified of the idea. She only lived five months after diagnosis. Five months.

  27. meowser Says:

    akaEloise: Yeah, re your coworker there doesn’t seem to be as much of a “lifestyle factor” for this particular form of cancer as everyone supposes (or for most of them, really). Like I said, my skinny health-nut neighbor got it, and an aggressive kind, too. I’ve actually left her messages to see how she’s doing, and haven’t heard anything back. I hope it’s because she thinks I’m a jerk. And visiting the facility beforehand doesn’t sound like a bad idea.

    TextualFury: Thanks for the insight on mammograms for women with disabilities. I suppose I could tell them about the Asperger’s, because even though it’s not a functional disability as such, I do regard it as a partial disability, largely because I never learned how to work with it when I was much younger and the diagnosis didn’t exist yet.

    Jenny: That does happen, and that’s why I’ve actually gone ahead and scheduled one. (Ulp.)

    PD: Great to see you here. And…LOL, no kidding. Especially since for us mega-boobed, they have to take multiple pictures.

    Spot Check Billy and Pencils: I’m very sorry for your losses. But here’s the thing. A very invasive, fast-growing cancer like the ones you describe might not be picked up even on yearly screenings. Aggressive lesions don’t give a shit that you just had a mammo two months ago. You’d pretty much have to have one every month — hell, maybe even every week — to make sure.

  28. Textual Fury Says:

    Technically a disability is anything that impacts function in your life. You are fearing the mammo because of many factors, including an inability to cope with your personal challenges. Therefore in this case at least your Asperger’s Syndrome is a disability.

    Disability doesn’t just apply to us wheelchair users. Don’t forget to value yourself into proper care.

    Also, thank you for making me aware I will need multiple pictures, finding out day of might have made me scream in frustration.

  29. E Says:

    Quite honestly, I’m pretty appalled at the post and some of the responses. It seems like trans men take better care of their female parts–and exert more pressure on each other to do so than some people here. If they can manage to take care of parts they’re not even supposed to have, there’s precious few non trans people who have as much of an excuse.

  30. meowser Says:

    Oh boy, here we go.

    E, nowhere in my post did I say I’m never getting a mammogram. In point of fact, since I wrote it, I actually have scheduled one, for St. Patrick’s Day.

    But the fact of the matter is that the risks and inaccuracy rate of the procedure and of over-treatment for noninvasive cancers and carcinoma in situ (pre-cancer) are largely whitewashed in most countries, and the stuff I’m talking about is not a bunch of groundless ninny-worry. Did you read the links I provided? Whether you were born with your female parts or not (and BTW, cis-men can get breast cancer too, although it’s less common), you still have agency as to what you put them through, and weighing ALL the risks only makes sense to me.

  31. E Says:

    I will give you credit for not saying you’d rather get cancer than get screened, but whatever. Make your choice and own it.

  32. aladoc Says:

    Not my area of expertise, but just a few points worth mentioning here.
    Population screening strategies are generally not arrived at by large randomized trials, partly since they would take decades to complete. Usually a panel of experts convenes and arrives at a series of consensus recommendations. So it is truly an open question whether the strategy that results is the most advantageous population-wide. To the extent that these experts have been sued or involved in suits over failure to diagnose cancer, I’m sure that experience is reflected in the guidelines.
    Cancer treatment protocols, on the other hand, ARE subjected to rigorous clinical trials with results usually gauged by 5-year survival or something like that. So if the guidelines recommend aggressive treatment for early disease, it’s because there’s strong scientific evidence to back it up.
    I think you’re viewing invasive and non-invasive carcinomas as different varieties, but really they’re different stages. So today’s non-invasive carcinoma could be next week’s invasive carcinoma could be next year’s metastatic carcinoma.
    Your commenter seems to suggest that lead time bias is entirely responsible for the improved survival seen with early diagnosis. I believe this is mistaken. From what I know, lead time bias does somewhat diminish the apparent benefit of early diagnosis, but it’s still very real. Here’s just one abstract that speaks directly to this issue: http://aje.oxfordjournals.org/cgi/content/abstract/113/1/93.
    Bottom line: everyone has to decide what’s right for them with regard to cancer screening. That process is aided by accurate information.

  33. Moue Magazine » Blog Archive » Market Based Medicine Says:

    […] been thinking about this lately because in Wednesday’s Shakesville Blogaround Melissa linked to this post at fat fu about why she won’t get a […]

  34. bri Says:

    A friend of mine (age 42) recently decided to take up a free mammogram offer (here in Australia). She has no history of breast cancer herself or in her family and is otherwise healthy. No lumps were able to be felt on examination and she was feeling fine. She hesitated because she had big breasts (F-G cup) but a friend convinced her to go through with it and they went together.

    They found cancer in both her breasts and when they removed some of her lymph nodes, she had extensive malignancies in those too. She has since had a double mastectomy, node removal and is now having chemo. If she hadn’t had that mammogram, chances are they would not have found the cancer until it was too late.

    So for all the false positives etc, there are women who have their lives saved because they had a mammogram. I would hate to be the one died because I just didn’t want a mammogram. The same sentiment applies to Pap smears…

  35. Health Scares R Us « fat fu Says:

    […] Recent Comments sassyblonde on Mental Health At Every Size: …Kat on On Hotel Housekeepers, Roseto,…bri on Keep Your Cameras Out Of My… […]


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