Screening, does it catch cancer early

RubyRed3

I have recently chosen to do advanced screening. My question is does it really catch breast cancer early? Has anyone ever seen statistics on this or even have personal experience? I am 34 years old if that factors into it at all. How can I be confident that screening everyou you months with mamo/ultrasound and MRI will catch a cancer early so that it is treatable?

gb2115

I think if you catch a cancer early via screening (i.e., assuming it can't be felt on breast exam), you can be extremely confident that it's treatable. I don't have statistics to back this up, but my tumor had grown large enough to be felt (1.2 cm) and was/is considered treatable.

RubyRed3

thank you gb2115! That is helpful and I'm happy your tumor is treatable!!! This is all so new to me so I thank you for taking the time to answer my question

Hopfull2

I wouldn't 100% count on ultrasound or mammogram. Many times you have be your own advocate. For me the radiologist Dr told me he saw something that looked like scar tissue from previous implants.he wanted to keep an eye on it he said for the next couple months. I felt the lump and I told him no keeping an eye it on so I pushed for A biobsy aglad I did because it came out as malignant. So when they tell u let's keep an eye on it don't. Push for a biobsy.

mustlovepoodles

screening caught my cancer early. They were actually watching a place in my left breast, which had been biopsied a couple of times. Imagine our collective surprise when a 1.9cm-something showed up in the right breast. I've always been a big believer in mammograms. But now I'm positively on the bandwagon.

Beesie

Catching breast cancer early is a good thing, and most early stage breast cancers are treatable, but it's important to understand that there is no guarantee. A small Stage I breast cancer that is HER2+, for example, can still present a significant risk of mets and therefore the treatment recommendation would likely include radiation (if the patient chooses to have a lumpectomy), chemo, Herceptin, and if the cancer is ER+, endocrine therapy.

mustlovepoodles

I couldn't feel mine either, KB. In fact, my doctor had done a full breast exam 3 weeks prior to the routine mammogram and she didn't feel anything either. And that damn lump was big as a cherry!

BellasMomToo

i guess you can say that screening caught my cancer early. My cancer was discovered during my annual mammogram. Just three weeks before, I had my annual physical with my GYN. He gave me a breast exam but didn't find anything. So I was surprised when a tumor was discovered from the mammogram. It didn't appear on the previous year's mammogram so it must have grown during that one year. The tumor wasn't noticed during my breast exam because it was right behind the nipple. Mine is HER+ which I believe causes the tumor to grow faster.

Hate to think what would have happened if I skipped or delayed my mammogram.

Butterfly1234

Screening caught my tumor early. I had a diagnostic mammogram and ultrasound back in April 2016 because of some weird pain. Nothing showed up and couldn't feel anything. However, routine mammogram in January 2017showed something suspicious. Ended up being 9mm IDC. Caught this sucker early and just under 1cm. In fact, when they injected radioactive seed prior to surgery they had a difficult time finding it because it was so vague. So yes on regular screenings!

ChiSandy

Another one whose tumor was found only because I had my annual screening mammogram. Had my baseline one at 38, every 5 yrs after that till age 50, every two years until 55, and annually thereafter. I was very lucky—not only was it early (though I wish it had been smaller), it was Luminal A and I was 64, which means it’s (usually—there are no guarantees) slow-growing. That means either that I will die of natural causes before it recurs, or if it does, I will likely die with it rather than from it. All because of that one little phrase “focal asymmetry not seen on prior mammograms.” Not to mention having those prior mammograms for comparison.

I just read somewhere that 50% of women aged 40-45 have gotten at least one screening mammogram and get screened at least biennially, despite some federal gov’t recommendations that screening “should be left to the discretion of the patient” for the 40-50 age group (as opposed to recommending a baseline age and screening interval). Actually, even though the average age at first diagnosis is 61, and it’s more common the older we get, I am a huge fan of starting screening at age 40, or at least while still menstruating, not only because breast cancer tends to be more aggressive in younger patients, but younger patients have fewer comorbidities and thus can withstand more aggressive treatments. It breaks my heart to see patients here diagnosed in their thirties, most with young children or on the cusp of starting families.

I know what statistics say about the societal cost of screening vs. false positives, “overtreatment,” and allegedly low numbers of lives saved by early detection. I know that there’s a chance that early (Stage IA or 0) Luminal A tumors diagnosed this late in life might not prove fatal even if untreated—but that chance is simply not high enough to risk rolling the dice just because I didn’t want the unwanted effects of surgery, radiation or endocrine therapy. And I also know that numbers do not think, feel emotion or pain, or need to function at home and in the greater world.

farmerlucy

Screening results may vary due to breast density, so be sure to ask about your personal breast density. MRI may be recommended in some cases.

Tresjoli2

so, just raising my hand for early screening. I had no lump and no family history. We caught this at my very first "baseline" mammo. I has a lot of dcis but only 1.5mm of IDC. But my FISH score was very high with a lot of comedonecrosis. I had an very agressive, super small tumor. As a result my prognosis is excellent. IMO every one shoud get screened at 40.

RubyRed3

thank you ladies for all of your stories!!! You have no idea how much it means to me I have a preventative mastectomy as an option but right now, I'm just not ready to make that decision. BUT for my own sanity I need to believe that advanced screening every 6 months with MRI/mammograms/ultrasound will catch something early if it comes up. I have spent the past 5 months stressing endlessly about my options and now again for my own sanity I need to table it. So screening it is.

ChiSandy

Ruby, no offense, but unless you already have/had or are at high risk for breast cancer (extensive family history, genetic mutations), preventive mastectomy is not advisable. Trust me, the worry you are putting yourself through is premature and unwarranted. Mastectomy is permanent, and it is major surgery with very real risks of complications whether or not you choose reconstruction. And even the most attractive and aesthetically pleasing result will not have the sensation of a natural breast. You can always, if necessary, eventually get a mastectomy. But once a breast is gone, it’s gone. Even though you believe you no longer need a body part or organ (and even if you actually no longer need it), removing it so that it will never develop cancer makes no sense. 40 years ago, women who were done having children had hysterectomies at the first twinge of a fibroid or ultra-heavy period. That is no longer done unless those organs are causing more pain and harm than they are worth, or there is a genetic or pharmacological risk (e.g., Tamoxifen can increase the chance of uterine cancer) that they could kill you.

I already had breast cancer, and a lumpectomy, radiation and am on at least 5 years of endocrine therapy. Therefore, I might have more at stake every time I get a semiannual exam or mammogram—after all, I’ve already proven that cancer was a possibility. But even that’s not enough of a risk for me to get a mastectomy now, and I don’t find those exams and screenings all that stressful.

Why were you chosen for screening at such a young age? Was it as part of an academic clinical study, or because you have an actual risk (family history, genetic mutation, or a history of lumps)? If you were chosen at random in the interest of science, you needn’t put the cart before the horse. There are legitimate reasons for preventive (“prophylactic”) mastectomies, but you haven’t mentioned any that apply to you.

Traveltext

Naturally enough men aren't screened for bc, but men like me with a first degree relative who died young from it and with a genetic predisposition to the disease should be admitted into public screening since we have a one in eight chance of getting bc. My diagnosis was delayed for three months because my PCP dismissed my breast lumps as nothing without even an examination. In the end, I demanded an ultrasound and, sure enough, the sonographer's eyes popped out of her head as she viewed the screen.

I know very many bc men and the story is similar; late diagnosis, poorer prognosis. Meanwhile the pink charities treat us as a minor feature because older bc males don't make good donation prompts.

MTwoman

ChiSandy, she does have genetic abnormalities.

RubyRed3, this is why you should stick to ONE thread, not start so many. Details get lost from thread to thread and people don't have the whole story.

RubyRed3

ChiSandy, thank you for your conments. I have had several lumps and biopsys as well as an ATM VUS. Which according to my genetic counselor and several other doctors I have spoken to is nothing to worry about as it is likely not something that will raise my breast cancer risk. So yes, MTwomen, your are right that I have an abnormality, it is just unclear if it poses a risk to me or not (likely not), however due to my personal history and the genetic results advanced screening or mastectomy is an option. I do not have any first degree relatives with breast cancer. I have one cousin and two great aunts who have had it.

RubyRed3

I should note, the cousin was 31 (BRCA-) at diagnosis and on my father's side and the two great aunts were 58 and 71 (BRCA-) at time of diagnosis and were both my maternal grandmother's sisters. I also have two other paternal aunts with breast cancer but they were BRCA2 positive and I have tested negative. Therefore their diagnosis doesn't really factor into my risk.

Traveltext

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Adelozier

hopefull you are my age. Id like to talk to you.

runor

Don't know if this is the right place to post this ... apologies if not.

I am very torn over the belief that early screening leads to better outcomes. Cures. I don't know that I believe breast cancer can be cured anymore. I think that word gets bounced around a lot but I don't see that there is very much evidence to support it. Just look at the women (on this site!) who had early stage, low grade cancers that were hit with the Cancer Trinity ( surgery, radiation, chemo) and here they are, several years later with a recurrence and metastatic cancer in other places. This is a cure? No it is not. It is a DELAY, a postponement, but not a cure.

So is it true to say that early detection leads to higher cure rates? I think this statement is poorly worded and this belief is a false one.

It might be more correct, more truthful to say that earlier cancers are more easily treated and you might have longer time before a recurrence, so in that way early detection leads to somewhat longer outcomes. But does early detection and treatment guarantee that you are done with breast cancer forever? No it does not.

I like the line that we insert in such instances 'of course there are no guarantees." Well if there is no guarantee, the word 'cure' should not be uttered as if it were a possibility. It should be completely off the table. No one should even suggest it. "We can cure you, but there are no guarantees.." What kind of crap is that, anyway? Confusing, double talking, saying one thing while meaning another. It gives a woman hope I one second, takes it away in the other. It's insane.

I am early into my cancer crash (no, not a journey, a journey is something you pack a lunch for and embark on in a happy mood, eager to see the scenery and eat your egg salad sandwiches by a babbling brook. This is not that.) I have been told that I am 'in a good position' yet so were many, many other women who are now dealing with this ugly beast a second time. Cure? Early detection leads to cure?

I think we need to be very, very careful with the language we use, the words we utter and explaining the reality of the situation to women and NOT glossing over it with slogans and platitudes and bumper stickers. I am finding it very hard to be hopeful some days. My focus is shifting from avoiding death by cancer to living life in spite of cancer. The two are not mutually exclusive. They can go hand in hand. But the more I read, the more I learn the more I realize that while early detection does have several possible beneficial outcomes, a CURE is not, truthfully, one of them. When NO WOMEN have a recurrence, when NO WOMEN die of breast cancer, we will have cured it. We still lose too many, even early diagnosed and easily treated, to call this cured. Early detection is good, but not the magic bullet and this truth is not made plain enough to women who, in terror, hang their hopes on early detection.

Traveltext

Well expressed and written runor. I'd just add: When NO WOMEN AND MEN have a recurrence, when NO WOMEN AND MEN die of breast cancer, we will have cured it.

runor

Yes, Traveltext, my bad for not being gender inclusive. I stand corrected.. We lose too many women and men to this disease!

Icietla

Does it detect breast cancer early -- not necessarily. Some breast cancers can grow quickly between mammogram intervals. Some breast cancers can be invisible in mammograms. Like Traveltext's, some patients' imaging and other evaluation efforts are needlessly delayed.

Can it detect breast cancer early -- Yes.

gb2115

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i think the earlier it's caught the better, but I don't like the implication that if you catch it early then it's definitely going to be cured. My oncologist has never used the word cure, and I understand why. With no test to guarantee you cancer free, it's impossible to declare someone as cured. What bothers me is the way the public uses early detection and cure in the same breath.

bravepoint

I'd been having annual mammograms for years which never detected anything. The lump that i found myself was so high on my chest that it would not have been seen on a mammogram. Screening early is definitely a good idea but won't always find everything. Self exams should be done too!

dtad

Hi everyone...I also agree that cure is not a word we should use. BC is a sneaky son of a gun and there are just no guarantees. Mammograms are important but certainly are not infallible. IMO MRIs should be more available to those of us with dense breasts. It is many times the only accurate screening tool, especially for ILC. Good luck to all navigating this complicated disease.

RubyRed3

runor, thank you for your honest thoughts. I am in such a tough place. It's like I can choose screening and hope to catch it early, which as you have stated isn't necessarily the answer. Or I can have a preventative mastectomy and risk surgery complications and live the rest of my like with reconstructed breasts, which I know could be fine but I'm only 34 and the thought of altering my body permanently when I might never get breast cancer is just such a hard decision. And even a preventative mastectomy doesn't guarantee I will never get cancer. Or maybe I have the procedure and never get breast cancer but I get some other form of cancer. It's really just a crappie shoot at this point. I feel like I have two bad options, although I am grateful to have these options....as strange as that all sounds. Right now I'm working on a second opinion. We will see where that takes me.

farmerlucy

I always figured my high risk screening would "catch" it early. Thus I did it from age 33 to 51. I paid thousands and thousands of dollars. My doctor was supposedly so good she didn't take my excellent insurance, so I paid out of pocket. The main reason I opted for the preventive mx was to stop dropping five thousand here, five thousand there for excisional biopsies, mammos, thermograms, galactograms. MRIs. Despite all that blue ribbon screening a stage 1 IDC was found in the final pathology. If I had insisted on the preventive mx a few years earlier, I might have outrun the beast. Now I will never know for sure.

As far as I'm concerned I'm cured. Yep, I may be living in the land of denial, but I'll stay here until something proves me wrong.

runor

RubyRed3:

I am in no position to offer advice, I am busy flailing around like a blind person trying to find my way. But I will tell you what happened in my surgeon's office after she told Hub and I that the 'thing' in my breast that no one thought was anything, turned out to be cancer ... much to everyone's shock ... I freaked out. CUT THEM OFF! CUT THEM OFF! I felt like I had time bombs strapped to my chest. You traitorous boobs, all those years of hiking you up in bras and slathering you with sunscreen and now you do THIS to me? How dare you?! Well I'll show you! Off with them, get them away from me, I can live without them! Goodbye bad boobies!

The surgeon was very patient as I came completely unhinged in her office. I may have uttered some not so nice words when she told me there was a silver lining. Silver lining? I have (insert bad word) cancer! There is no silver lining. I was crying and ranting and saying I want them both cut off. She very calmly picked up her pencil and told me she was booking me for a lumpectomy. Lumpectomy! Didn't you hear that I have time bombs on my chest? Where were you for that, Dr. Doom?

She said, women, just getting the news I had received, make knee jerk reactions based in fear and panic, NOT hard science and evidence. She said that most women, hearing they have cancer, want to be rid of their breasts and never go through this terror and emotional agony again. So yes, she could cut my breasts off, if that was what I really wanted. And that might take away my risk of breast cancer. But it will NOT take away my risk of lung cancer or skin cancer or heart disease or car accident or slipping in the bathtub or eating a poisonous mushroom. She said all women in my situation feel the only threat to their life is breast cancer and that by sacrificing their breasts, they will be safe forever to live into old age and die at a picnic after eating a big slice of apple pie. And that just is not true. So before I make the irreversible decision to lop my breasts off, I should sit, and think, when I've had some rest, when I've given it some thought and then call her office with my decision. BUt to take my word right then and there to do a double mastectomy based on the pathology report before her, no, she needed me to give it some thought.

She also assured me, several times, that I had equal life expectancy with lumpectomy and radiation as with total mastectomy. She said if she felt my life would be better with a mastectomy, that is the only option she would have offered me. But she has evidence before her that says a lumpectomy and rads and I will have equal life expectancy.

I came home. I cried a lot. I thought about dying. I thought about life with one boob. I had always thought it wouldn't bother me. That I could have a mastectomy and never look back. I know many women who have mastectomies and have amazing lives after. But when I had time to sit and think, without fear screaming in my ears, I realized that I was not yet ready to give up my breast. If it meant saving my life, I would. But that is NOT my situation at this time.

RubyRed, I wonder if a doctor has told you that you are at real risk of cancer, because that situation does exist for some women with specific genetics for it. You can look into that more on this site. Since you are so young, with lots of life ahead of you, it may make sense to have preventative mastectomies. But before you make such a huge decision, you need the guidance of a medical professional who will not allow you to make a sacrifice that isn't truly benefitting your life in any real way. I have a friend who is waiting for her double mastectomy, because she is out of options. But if you have options at this stage, make sure you have examined all of them and gathered input from several medical sources BEFORE you make any large decisions that are permanent. Please.

MTwoman

runor, WELL SAID. I didn't have that same knee jerk reaction, but ended up with mx simply because I had multi-focal disease and that was what was recommended. I never once thought about bmx, just because I, personally, couldn't see lopping off a breast that hadn't done anything wrong lolol We are all different, and our risks are different. But I believe that you are very correct in advising this decision to be done with lots of clear, scientific evidence and info about current personal risk and the actual reduction of that risk. Although, you are also right, that it only reduces the bc risk (and NOT to 0%), not the cardio vascular risk, or the diabetes risk, or the choking on a chicken bone risk. And it actually increases the lymphedema risk (which I hear is not fun).