Tuesday, May 26, 2015

The imperfect mammogram

Sometimes I start to think, which can be a dangerous proposition and something that my husband believes I should not do too frequently. One thought that has wandered through my brain is that we make assumptions about mammograms and other medical tests and procedures. I also found an article that agrees with me.

To give a little history, I had a benign fibroadenoma at the age of 23, which was three years after my thyroid cancer, and have had mammograms since then. Fibroadenomas are benign and common in younger women but can put a woman at 1.5 or 2x the risk of breast cancer later on. (A little factoid I just learned and wish I had known decades ago.)

But after decades of mammograms, and breast cancer and a later fibroadenoma at the end of chemo, I can tell you I never felt they so wonderful or perfect. My first fibroadenoma was found by me and confirmed by a mammogram (my first). My breast cancer was found by a mammogram. My second fibroadenoma was found by an MRI and grew during chemo.

There has been a lot of disagreement, false information, arguments, stories about mammograms saving lives, and more in recent years. Komen says mammograms save lives (as her sister wanted - but that's another story). The AMA, ACS, and other groups have their own opinions.

But lets take a step back, as this writer describes, and think about the real mammogram numbers and results. Some cancers are missed on mammograms. Sometimes mammograms find benign conditions. These can lead to more testing or procedures or even over treatment.

First, no medical procedure, test, surgery or whatever is perfect. There is always a margin of error. Strep tests are good 99% of the time, flu shots don't prevent all cases of the flu, any surgery could have complications. Second, as patients we make assumptions that a medical whatever is going to save us. A doctor will come along and be able to save us from whatever. They do their best but research is always on going to learn more.

Screening for cancer can save lives but none of the tests I know of are perfect. A high number on a test can be a sign of cancer but it could be caused by something else. I am all for cancer screenings but we can't rely on them completely. We need to accept that medicine is not perfect but it is all we have.

2 comments:

Jenny Bender said...

Since being diagnosed with breast cancer at 39 (and only because I found a lump, not my doc, not any of the recent blood work I'd had done), I try hard not to live in fear about everything that could be going on un-detected in my body. As you write, mammograms -- like so much else in the medical profession -- is flawed, uncertain, unknown. Everyday, I have to remind myself to just keep living and not get too caught up in the "what if?" fears.

Jenny Bender said...

Since being diagnosed with breast cancer at 39 (and only because I found a lump, not my doc, not any of the recent blood work I'd had done), I try hard not to live in fear about everything that could be going on un-detected in my body. As you write, mammograms -- like so much else in the medical profession -- is flawed, uncertain, unknown. Everyday, I have to remind myself to just keep living and not get too caught up in the "what if?" fears.