New Article from the LA Times On MAMMOGRAMS...interesting!!!

gscott

New Article from the LA Times On MAMMOGRAMS...interesting!!!

gscott

http://www.latimes.com/features/health/la-he-breast-overdiagnosis17-2009aug17,0,5184447.story?page=1

"Dr. Eric Winer, director of the breast oncology center at the Dana-Farber Cancer Institute and chief scientific advisor for Susan G. Komen for the Cure acknowledges that messages about mammography may need revamping.

"As painful as it is to admit, we have oversold mammography to the American public," he says. "Frankly, I don't know what to do with this. On the one hand, I don't want to push people away from mammography, but I don't want to encourage them to have misconceptions about mammograms either."

gscott

Since this in on the topic of mammograms, does anyone know how a mammogram differs from a TV, Computer, or flying on an airplane? Are they all the same. Are some worse than others? Where do we find this info. Someone on this forum said that flying in an airplane is just as bad and I can't find that info.

Leia

I found this quote, interesting:

"But radiologists are unlikely to adopt guidelines that call for a wait-and-see approach, says Dr. Fred Vernacchia, a radiologist and medical director at the San Luis Diagnostic Center in San Luis Obispo. Mammograms are the No. 1 source of malpractice lawsuits against radiologists, he says, and this creates an incentive to overdiagnose breast cancer.

"The choice is, overbiopsy and overdiagnose -- or live through another lawsuit," he says."

Well, that is my experience. In January, 2009 I had a Birad5 Breast MRI. The Mammo was Birad 4. Ultimatley, the Ultrasound Biopsy was Birad 1. No Cancer. 

The docs? They didn't believe it. They then wanted me to do a MRI-Guided biopsy. For just the reason stated, above. "Overbiopsy and overdiagnose -- or live through another lawsuit."

I did not have the MRI-Guided Biopsy. I just said, NO.

Six months later, they wanted me to have another breast MRI. (NOT cheap) I refused. I did have another Mammo/Ultrasound and it was Birad1. 

No cancer. Duh. 

People express, wonderment, at these "runaway health care costs."  

I shake MY head, in wonderment. At this apparently widespread belief that we can continue to do all of these "treatments" and it doesn't cost, anything.

CapeBretongirl

Gscott, thank you. It is very interesting. My brother is a general surgeon. He has been asserting the identical information for at least ten years. Remember that old saying "What you don't know, won't hurt you" Angel

Sassa

In my case, a very astute radiologist saw something on my mammogram that he couldn't ID as cancer (even after follow up compression scans and an ultrasound) but  strongly recommended a biopsy (Birads classification was 3).

Yes, it turned out to be one of those very aggressive tumors that didn't show on the mammogram and probably would have metastasized within a few months.

I still feel the mammogram saved my life because of the radiologist's skill and gut feeling about the findings.

LRM216

Sassa - I agree with you totally.  I am 62, have no cancer whatsoever on either side of the family and have diligently had a mammo yearly since the age of 40.  In 2008, my daughter had a rough year healthwise (not breast related at all) and was in and out of the hospital.  I missed my 2008 mammo and truthfully, did not give it much thought as I had never even been called back for any of them.  I figured I was safe.  In late Feb. of 2009, I made an appt with the breast center for my yearly mammo and with my gyno for my pap smear.  Lo and behold!  Called back 2 days later for compression mammo and US.  Biopsy a day later revealed a 1.2 cm nodule deep in breast which was not palpable at all.  I was diagnosed days after my 62nd birthday with IDC, triple negative (which I knew nothing about - assumed breast cancer was the same in all women!).  Fortunately (I hope), they claim it was found early, and with my lumpectomy, 4 DD AC, and 4 DD Taxotere, then on to rads for 6 wks., they hope I will not see it back.  If I hadn't had that mammo last Feb. and continued on thinking I was still "safe" and "cancer free," I am sure my prognosis would be different.  While I see what the article is saying - the difficulty is going to be deciding who is safe to forego yearly mammos and who is not. 

Linda 

LisaAlissa

Hi GScott!  Whether it is "just as bad" I couldn't say.  I suppose it depends on where you're going, and how often you go there! 

The patient/public info website of the American College of Radiology and the Radiological Society of North America discusses the doses of ionizing radiation from various studies and compares them to other exposures.  The "Safety" page from that web site:

  http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray#5 

says (among other things) that average person gets an effective annual dose of 0.03 millisieverts (mSv) from naturally occuring radioactive materials and cosmic radiation from outerspace.  That natural background amount varies around the country.  For instance, those at altitudes get more exposure (less atmospheric protection from cosmic radiation)--as much as 1.5mSv more than those at sea level.  Those who have radon gas exposure may be picking up another 2mSv per year.

They note that a coast-to-coast round trip plane trip will add .03mSv of exposure. 

The web site includes a chart that compares the amount of ionizing radiation for various x-ray studies to the time it would take an average person to be exposed to the same amount of background ionizing radiation.  They calculate that a mamogram is .7mSv of ionizing radiation...they say that that is comparable to 3 mo. of background radiation (or a little over two coast-to-coast round trips).

Minimizing lifetime exposure is clearly the key.  So a lower-dose mammography machine (when available) is definitely worth selecting!

HTH,

LisaAlissa

Anonymous

Well, I wish my 2004 mammo had found my cancer.  I had a large tumor..found it accidentally in Dec.  No, I didn't do BSEs..shame.  I had five out of nine nodes positive with extranodal extension.  My faith in mammos went out the window.  I realize this is not what the article is about...well sort of not.  I have A dense breast.  Yep, one's gone.  I really didn't think my big lump was cancer and considered not having it checked out.  Anyway, I did and believe it was a cyst.  I've had ultrasounds that turned out to be cysts. 

Now when I go for my mammo I really don't get upset because it didn't find the first one (and I had a second tumor in another quadrant of my breast that it didn't pick up..picked up with CT scan), and I wonder if it would find another one. 

I guess we just continue down the same old road until something better comes along.  Geez!  How long!!!!!!!!????????????

baywatcher

If I could turn back time I would never have a mammogram again.

RunswithScissors

I wish I had never had a mammo, and I've refused them after my first one.

 Here's why: 

It's well established that there is no safe dose of radiation. It's well established that radiation exposure is cumulative. 

Yet radiologists assure us that the mammo is "safe"  because it is such a low dose.  They say this to everyone even though they never ask how much radiation exposure you've had in your lifetime- 

how is that sound science? It's not. It's completely illogical. 

They KNOW that  the mammogram will CAUSE cancer in some women - but that's  ok! 

THEY have decided that the statistical benefits outweigh the risks.  Anyway, the patient will never know if she is one of their sacrificial lambs, there is no way to tell  if her cancer was caused by the mammo or not -   

Then there is the question of whether squashing a cancerous tumor squeezes microscopic cells into the bloodstream....  So the test can give you cancer, and if you already had cancer, it might give you mets.... Great.