Mammogram Sham?

I'm a busy woman. (Last night I held my face over a steaming bowl of pasta I was making for dinner and wondered if that could count as a "getting a facial.")

Busy I may be, but there is one thing I make sure to schedule time for: my annual mammogram. Now I'm flabbergasted and pissed about the new guidelines coming out about mammograms. I knew the news was out there that some doctors are recommending changes to the way women are screened in the U.S., but I didn't focus on it.

After all, I had just gone for my annual mammogram. Ironically, while I was in the waiting room thumbing through the glossy magazines, I came across an article about this. I read it, then took off my gown and got my mammogram. You would too if you'd watched your cousin die from cancer.

 In fact, if you had to make a Top 10 list of the things I am really afraid of, sharks and breast cancer would be on it. (I can trace the shark part back to childhood, when I read the bulk of Jaws before an adult could stop me. While staying at a seaside inn.)  But I was also very young when I stood at the bedside of my older cousin and watched her pass away, leaving three beautiful children befret. She had breast cancer, seemed to beat it, then later it spread and killed her. Her sister also had it. Breast cancer is a beast, like Jaws, that I want to avoid.

So I'm considered high risk, even though I don't have a direct maternal link to breast cancer. (The cousins are on my father's side.) But because of this, I have always been aware of the issue and gone for my mammograms. 

I've looked at earlier articles about this in the New York Times, but I just couldn't wrap my head around it. How could everything we've been told be wrong? I know this happens all the time with other things - one day we're told coffee is bad for us, the next day it's found to have positive health benefits, etc. But this is different. This is big.

This week there was no avoiding it. Because NPR did a two-part story on the changing recommendations. Since I am a news junkie but don't have time to read much, the radio has become my main source of news. I would be lost without the BBC and NPR and WBAI, my local progressive station.

So the new task force recommendations say you can wait until you are 50, and then go every other year. If you talk it over with your doctor. But how many women will interpret this as meaning that they don't need to worry about this? I already know scores of women, some even high risk, who have put off going for their mammograms. It's uncomfortable, and besides, when you are a busy woman, it is easy to let this slip and slide to the bottom of your to-do list.

One of the doctors quoted on NPR said that "screening early saves more lives, but it has to be counterbalanced by the harms that are done." Those harms? Too many false positives, needless testing, and the "stress and worry" that women undergo.

But if you would save one more life for every 100 women screened, is it worth it?  What if I you are that one? What if I am? What if it's my mom?

So I am just really confused. (I loved it by the way, when NPR reporter Michelle Norris pressed the doctor she was interviewing from the task force earlier this week and said, "isn't this condescending to women?" You go girl. I mean our whole lives are stressful!)

The whole debate raises other issues as well. Will this send a signal to insurance companies to deny coverage for younger women who want to be screened? Many researchers, including the highly regarded Dr. Susan Love, say that breast cancer rates for young women are rising in the U.S. How will these women prove to their insurance company that they are high risk? Would my insurance company accept my "cousin" factor? Why aren't more people talking about preventing breast cancer and how our rates compare to women in other parts of the world? Why do Hispanic women who move here see a rise in their rates of breast cancer?

The new report even says that self-breast exams aren't worth it. Because too many women come in thinking they have found something and then have to go through all the testing. But some women do find things. They find cancer.

This is an original New Jersey Moms Blog post. When Theta Pavis isn't scheduling her latest mammogram or bugging her friends to make theirs, she writes, edits and ruminates from her home office in Jersey City.