I didn’t realize how harrowing until I was back at the scene of the procedure and they took my blood pressure right after the mammo. My blood pressure is always good. Once I had a weird strep that closed my throat but didn’t exhibit any other symptoms. I started choking so Jon took me to the ER. Blood pressure, fine. Another time I experienced 10-hour gall bladder attacks that had me awake all night with phone in hand deciding whether or not I should call 911 or risk dying alone. It felt as though someone wrapped me in barbed wire and kept tightening the torso garotte – yet my blood pressure was perfect. But yesterday, just sitting there after the “m-gram” my pressure was up 15 points on both top and bottom. I commented on this to the attendant who said “That happens a lot, we’d only be worried if it is high on a regular basis.”
So what stresses women about mammograms? (We know what stresses men – merely talking about them (any guys still reading this?)) Personally I didn’t think they did cause me stress me. I mean the biopsy thing was stressful especially when they kept screwing up the dates and the times and giving me misleading information about what was happening when, because that made me wonder if they had any clue at all. In fact I refused to let one renowned dude perform the procedure because I’d lost so much faith in his ability to communicate that I wasn’t sure he’d get the right boob. (I like the word “boob”, it sounds funny and is typically inappropriate in polite conversation.) But I have no family history of breast cancer and only one of the indicators (I’ve never been pregnant), so I never really believed I gave mammos much thought.
If it isn’t intense physical pain that spikes my blood pressure, (okay I’ll admit that while it may be more painful for big or small-chested ladies, in my experience those of us in the middle seem to experience more discomfort than actual pain and it is for such a short amount of time, I don’t find it that hard to just suck it up and wear the big girl panties), then what?
I’m now thinking it was the very calm (I instinctively think all very calm people are about to go insane), trying-to-be-kind technician who gently pushed back my hair. That freaked me out. It seemed way too personal, something my husband might have done. I also thought it was weird because my hair is shoulder length and I didn’t think that it could interfere with the imaging. I’m non-tactile on the best of occasions, and this woman trying, I am sure, to display gentleness as she groped me and squished me between two hard, cold surfaces (ADVICE: ladies try not be the first appointment on a cold winter’s morning) had made it personal when I wanted it completely cold, clinical and technical. I was in my protective robot-mode and she made me think about my vulnerable situation and the outcome that I could only hope was good.
I got good news and I am very happy with one change they made. After the mammogram, I sat and waited in the “lounge” flipping through the trash magazines I usually reserve for hair appointments until the doctor saw me and reviewed my results. Prior to this I waited days if not a week for a result. This sanity-saving step could be a positive outcome of the report that will be the focus for the rest of my blog; I’d like to think so.
In November of 2009 the US Preventative Services Task Force released a report about mammography and breast self exam. According to a section entitled “Importance”, the Task Force was created because “Breast cancer is the second-leading cause of cancer death among women in the United States. Widespread use of screening, along with treatment advances in recent years, have been credited with significant reductions in breast cancer mortality.”
Here is a link to the full report and the December rewrite meant to appease the outraged public. http://http://www.uspreventiveservicestaskforce.org/uspstf09/breastcancer/brcanrs.htm
The USPSTF released a report that caused quite a furor because it recommended against the current, seemingly successful practice and stated that women need not get annual mammograms if they are 40-49 and have no predisposition to the disease, because the number of lives saved for women in this group who had mammograms was minimal. The report did not identify whether any women who had early mammograms lived longer and better while still eventually succumbing to the disease.
“The USPSTF emphasizes the adverse consequences for most women—who will not develop breast cancer—and therefore use the number needed to screen to save 1 life as its metric. By this metric, the USPSTF concludes that there is moderate evidence that the net benefit is small for women aged 40 to 49 years.”
Ya, well, if I am the one out of a thousand or 100,000 who benefits, it’s kind of hard to think of my life falling within the acceptable percent of error.
The report also stated that the stress experienced during a false positive made it all so very counter productive.
“The harms resulting from screening for breast cancer include psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results.”
And I am here to say – I had the false positive; I had the three months of stress where I wondered what it might be like to lose a breast; I had the inconvenience of having the biopsy during a visit from out of town family, and I have the scar and the micro chip in my breast to locate where my cyst was. And I don’t regret it one bit. For me the psychological and physical harms of having a treatable but undetected breast cancer far outweigh the harm of the screening and treatment. And if my blood pressure gets ratcheted up 15 points during the process but I am ultimately cleared or treated, I am okay with that.
New wording added in December 2009 advises discussing this with your doctor and making the decision together. And that’s fine with me, too, but what I am not okay with is the message this report might be sending that minimizes the threat of breast cancer and therefore can become an easy excuse for avoiding the discussion or the screening.
In doing some research for this blog I found Susan G Komen for the Cure to be the most helpful website. I especially recommend the breast cancer warning signs and the breast cancer risk factors. The group is understandably protective of its name and does not allow links easily, but it’s worth the effort to google the name Susan G Komen for the Cure if you have questions.
I have no soap box to jump off and no cute ending to wrap this all up, so I’ll just stop ranting and end with a prayer for all of us to enjoy good health and good medical treatment in 2011 and a reminder to be your own advocate.
(c) 2011 by Alison Colby-Campbell