New Mammogram standards FYI

[missy]

"

FDA Orders New Mammogram Standards for Women With Dense Breasts​

Written by Jay Croft

March 9, 2023 -- Women with dense breast tissue will be given additional information at their cancer screenings under new rules adopted by the FDA.
Providers of mammograms will have to tell women that their tests are harder to interpret and suggest they speak with their doctors about more testing, the FDA says.
This will lead to greater detection of breast cancer earlier, advocates say.
Breast cancer is the second most common cancer in American women, after skin cancers, says the American Cancer Society. This year, about 300,000 new cases will be diagnosed, and about 43,700 women will die from breast cancer, the organization says.
“Today’s action represents the agency’s broader commitment to support innovation to prevent, detect and treat cancer,” Hilary Marston, the FDA’s chief medical officer, said.
Most states require that women be told when their mammogram finds they have dense breasts. The FDA decision applies a minimum standard for 8,700 facilities across the country, and states can still require more explicit wording, The Washington Post reported.
“Dense breasts have relatively less fatty tissue and higher amounts of glandular and fibrous connective tissue,” The Post wrote. “Nearly half of all women 40 and over have the condition. Dense breasts can appear white on a mammogram — but so does cancer, making it difficult for radiologists to detect tumors.” Women with dense breasts also face a higher risk of developing the disease.
Mammogram providers have 18 months to comply with the standards. Information about dense breasts will be included in a letter to patients and their physicians.

"

 

[DAF]

The timing on this is so en pointe...just had my annual mammography screening this morning, and I had been told in the past that I have dense tissue. Results were WNL.

 

[Demon]

Timely indeed. I need to schedule mine.

 

[tyty333]

Yep, I've got them. When I had my first physical with my new doctor (several years ago), she sent me for a mamo and an ultrasound
evaluation. They then sent me to a breast specialist (forget the technical term for a breast specialist). That doctor sent me for a 3D
mamo which was new in our area at the time. I had to pay out of pocket for it but I needed peace of mind. The doctor that evaluated
it said they saw nothing of concern. Of course the very next year my insurance started paying for 3D mamos (yeah)! From then on it
appears that they go back and compare the previous year's mamo to make sure nothing has changed/grown. It is always a relief to
get the results of "no change".

 

[Mreader]

The timing on this is so en pointe...just had my annual mammography screening this morning, and I had been told in the past that I have dense tissue. Results were WNL.

What does WNL stand for?

I also have density, and when I lived in Louisville, I would always be recommended for an ultrasound because microcalcifications were found. So it would always kick to a diagnostic rather than a routine. Then I moved to Texas, and they never did that which always worried me. Like why were they so much more interested in extra testing where I had previously lived? I think this year I might ask about getting an ultrasound.

 

[missy]

My breasts are in the highest density category and I’ve been doing mammos with breast ultrasounds yearly since I was 35 due to my extremely dense breasts. Have also been doing 3D mammos since they’ve been available

What does WNL stand for?

WNL means “within normal limits”

However in graduate school we were taught it means “we never looked” lol
One needs more specific details rather than just WNL IMO
and hopefully it’s more detailed on the report which I highly recommend getting a copy of every single time

 

[Mreader]

My breasts are in the highest density category and I’ve been doing mammos with breast ultrasounds yearly since I was 35 due to my extremely dense breasts. Have also been doing 3D mammos since they’ve been available




WNL means “within normal limits”

However in graduate school we were taught it means “we never looked” lol
One needs more specific details rather than just WNL IMO
and hopefully it’s more detailed on the report which I highly recommend getting a copy of every single time

Yes, I started at that age 2 because my mom had breast cancer in her 40s. Yeah I’m really gonna ask about that ultrasound now!

 

[tyty333]

@Mreader...I read that as you started at age 2. I had to reread it 3 times to actually make it make sense!

 

[Mreader]

@Mreader...I read that as you started at age 2. I had to reread it 3 times to actually make it make sense!

Omg! It should have said “too”. I use dictation a lot and failed to proofread. Gah.

 

[autumngems]

Dense here also, I go for mine next Friday.

 

[Bonfire]

I’m happy to see this. It’s about time! This information is important and doctors need to order ultrasounds and MRIs for their patients with denser breasts as part of basic screening. It hasn’t been routine in the past. Information is power, but you have to know that you have these other screening options if you have dense breasts. Insurance needs to cover them for general screening not just diagnostic. This is a step in the right direction.

 

[jbake]

I’m happy to see this. It’s about time! This information is important and doctors need to order ultrasounds and MRIs for their patients with denser breasts as part of basic screening. It hasn’t been routine in the past. Information is power, but you have to know that you have these other screening options if you have dense breasts. Insurance needs to cover them also. This is a step in the right direction.

Because of my family history, my GP referred me to a breast oncology specialist. She has me go for a regular mammogram once a year and a breast MRI annually because I have extremely dense tissue. So I am checked out every 6 months. Because of the calculations her office did, insurance does cover most of the cost. It’s still some out of pocket cost for the MRI, but worth the peace of mind it brings.
The MRI isn’t very fun, but I imagine it’s a whole lot easier than treatments

 

[CaseyLouLou]

"

FDA Orders New Mammogram Standards for Women With Dense Breasts​

Written by Jay Croft

March 9, 2023 -- Women with dense breast tissue will be given additional information at their cancer screenings under new rules adopted by the FDA.
Providers of mammograms will have to tell women that their tests are harder to interpret and suggest they speak with their doctors about more testing, the FDA says.
This will lead to greater detection of breast cancer earlier, advocates say.
Breast cancer is the second most common cancer in American women, after skin cancers, says the American Cancer Society. This year, about 300,000 new cases will be diagnosed, and about 43,700 women will die from breast cancer, the organization says.
“Today’s action represents the agency’s broader commitment to support innovation to prevent, detect and treat cancer,” Hilary Marston, the FDA’s chief medical officer, said.
Most states require that women be told when their mammogram finds they have dense breasts. The FDA decision applies a minimum standard for 8,700 facilities across the country, and states can still require more explicit wording, The Washington Post reported.
“Dense breasts have relatively less fatty tissue and higher amounts of glandular and fibrous connective tissue,” The Post wrote. “Nearly half of all women 40 and over have the condition. Dense breasts can appear white on a mammogram — but so does cancer, making it difficult for radiologists to detect tumors.” Women with dense breasts also face a higher risk of developing the disease.
Mammogram providers have 18 months to comply with the standards. Information about dense breasts will be included in a letter to patients and their physicians.

"

This is interesting. I just asked my PCP about this because every time I go for a mammogram they tell me I have dense tissue. Her response was ‘tell them to put that in the report and then next time I will order a 3D scan’. This is so frustrating. I don’t want to wait another year.

 

[missy]

This is interesting. I just asked my PCP about this because every time I go for a mammogram they tell me I have dense tissue. Her response was ‘tell them to put that in the report and then next time I will order a 3D scan’. This is so frustrating. I don’t want to wait another year.

Ridiculous. You should have been given the breast ultrasound option with each mammogram with dense breasts. I have been doing both now for over 2 decades. With dense breasts you cannot fully rely on the mammogram results since they make it hard to read so an ultrasound is important. If you are concerned tell your doctor you want an order for a breast ultrasound now. No need to wait for the mammogram.

 

[Bonfire]

You could also ask your doctor to order a breast MRI.

 

[missy]

https://www.mdlinx.com/article/fda-updates-mammography-regulations-what-your-patients-need-to-know/PW7gUDSvvpFkRJp1NZjDs?show_order=1&utm_campaign=reg_daily-alert_230508_daily-nl-am-v3_registered-users-a90&utm_source=iterable&utm_medium=email

"
FDA updates mammography regulations: What your patients need to know
By Carol Nathan | Medically reviewed by Jeffrey A. Bubis, DO, FACOI, FACP | Published May 4, 2023

The FDA has updated the official mammography regulations, as overseen by the Mammography Quality Standards Act (MQSA).

The updates include breast density reporting requirements, FDA oversight of mammography facilities, and helping physicians assess mammograms.

When referring patients for mammography, physicians can make sure the facility is MQSA-certified, which can be confirmed by searching the relevant FDA database.

The FDA has updated the federal mammography regulations, with a special focus on breast density reporting requirements, FDA oversight of mammography facilities, and helping physicians assess mammograms, according to the press release.[1]

The updates are intended to improve the communication of mammography information to patients and their physicians in order to provide more informed decision-making.

Receive the full benefit of mammography

The official FDA mammography oversight program is called the Mammography Quality Standards Act (MQSA) of 1992. According to a rule by the FDA, published in the Federal Register, the goal of the MQSA is to ensure that patients receive the full benefit of mammography,[2] which means:

The mammography images need to be high quality
The testing needs to be done by qualified technicians
Equipment needs to be properly tested and functioning
Results need to be interpreted by qualified physicians
Results need to be communicated clearly and properly to patients and their referring healthcare professionals
Breast cancer statistics

The FDA updated these requirements based on the high prevalence of breast cancer in the population. Breast cancer is the most common nonskin cancer, and the second leading cause of cancer death after lung cancer.

According to the CDC, as discussed in the FDA rule, more than 254,000 women were diagnosed with breast cancer in 2018, and more than 42,000 women died of the disease. These numbers are projected to have increased since then.
Dense breast tissue

According to the FDA press release issued March 9, approximately half of women older than 40 years of age have dense breast tissue, which can make cancer more difficult to detect via mammogram. In addition, research shows that having dense breast tissue is a risk factor for developing breast cancer.

The new regulations include specific language that explains how breast density influences the accuracy of mammography, and recommends that patients with dense breast tissue discuss the cancer risks with their physician.
Amendment details

The MQSA was updated and modernized based on new technology developments and current scientific research, including breast density information, according to the FDA rule. The new update requires the following:

The summary of the mammography report be written in lay terms that patients will clearly understand
Identifies whether the patient has dense or nondense breast tissue
Includes information on the significance of breast density be included
Establishes four categories for reporting breast tissue density
The new required wording of the four categories of breast density reporting is as follows:

The breasts are almost entirely fatty
There are scattered areas of fibroglandular density
The breasts are heterogeneously dense, which may obscure small masses
The breasts are extremely dense, which lowers the sensitivity of mammography
In addition, the update strengthens the FDA audit and oversight of mammography facilities and creates tools to deal with noncompliant facilities.

For example, it allows the FDA to suspend or revoke mammography facility licenses when necessary, provides processes to follow if the facility failed to receive accreditation after three attempts, and creates new rules for managing personnel records of mammography facility employees.
The FDA oversight of mammography facilities also now includes the FDA’s ability to communicate directly with patients and physicians if a facility did not meet quality standards. The goal is to make sure that any patients who might need a repeat mammogram due to deficiencies at the facility are made aware of this need. This will empower patients to make the best decisions regarding their breast healthcare. The new amendments are required to be implemented within 18 months.

“[This] action represents the agency’s broader commitment to support innovation to prevent, detect and treat cancer.”
— Hilary Marston, MD, MPH, FDA Chief Medical Officer
“Since 1992, the FDA has worked to ensure patients have access to quality mammography,” Marston said in the press release. “The impact of the Mammography Quality Standards Act on public health has been significant, including a steep decrease in the number of facilities that do not meet quality standards. This means that more women have access to consistent, quality mammography. We remain committed to advancing efforts to improve the health of women and strengthen the fight against breast cancer.”

What this means for you

The FDA's updated mammography guidelines mean your patients will now have more information about their breast density, and you will have more information to discuss with them. You can also be reassured that the facility that conducts your patients’ mammograms is high quality. When referring patients for mammography, it makes sense to ensure that the facility is MQSA certified, which can be confirmed by searching the FDA database. [3]
"

 

[RMOO]

@Mreader...I read that as you started at age 2. I had to reread it 3 times to actually make it make sense!

Yeah, me too! I'm like, wow, they start screening that young? Holy cow! Guess, I'm a little dense in more ways than one

I got 'em too. I started with the 3D mamm just months before insurance started covering it as routine. It was worth the relatively small out of pocket, and then it was covered since. I wonder now how long it will take for the insurance companies to cover MRI for routine scanning. My daughter just had her first breast MRI and said it wasn't too bad, that the hardest part was holding still (with arms raised overhead, etc) for the time required. I'll bring this up to my gyno the next time I'm due.

 

[momofive]

So, I was told most women's breasts get denser as we age. My facility has been doing the "slicing" type mammography and an automatic ultrasound every year.

 

[missy]

"

What Our Patients With Dense Breasts Deserve to Know​

— More research is key before the Task Force can offer evidence-based recommendations​

by Carol M. Mangione, MD May 25, 2023

Carol M. Mangione, MD, is immediate past chair of the U.S. Preventive Services Task Force.
Nearly half of all women have dense breasts, which increases their risk for breast cancer and means that mammograms may not work as well for them. While many women already know this information about their bodies, starting next year, a new FDA ruleopens in a new tab or window will require that clinicians notify all women if their mammogram shows that they have dense breasts. The challenge is ensuring our patients understand what to do about it.

When my colleagues and I at the U.S. Preventive Services Task Force reviewed all of the latest scientific evidence around breast cancer screening for our new draft recommendationopens in a new tab or window, it became clear that there is not enough research available to tell us whether and how women with dense breasts should get additional testing. The research doesn't show whether the right answer is an ultrasound, an MRI, or something else entirely. And it doesn't tell us how often these additional screenings should happen.
There's no question that there is a problem here. Women deserve to have high-quality science available to guide their decisions on whether, when, and how to get screened -- especially those women who we know are more likely to get breast cancer. Yet, this information is woefully absent from the scientific literature. No matter how much we may want to, the Task Force can't make a recommendation on any additional tests for women with dense breasts without that evidence. We simply can't be confident that what we're recommending will help women get and stay healthy.

All our recommendations are focused solely on what high-quality science shows, not on what we all wish we knew. Because science on additional screening is lacking here, we are issuing an urgent call for more research. All health researchers and research funders should consider this a top priority. They must work as quickly as possible to complete the appropriate studies and allow us to come to a strong recommendation that can help women with dense breasts and their clinicians know the best screening approach.
In the meantime, the most important thing we must make sure our patients know is that starting to get screened for breast cancer every other year when they turn 40 just might save their life. Mammograms are an imperfect yet critical tool in helping find and treat cancers early. Getting timely mammograms is vital for women with dense breasts, who should then talk with their clinician about which -- if any -- of the additional screening approaches are right for them. These decisions should be made between patients and clinicians with as few barriers to care as possible.

Women have long been underrepresented in the scientific literature. As half of the population, we are equally worthy of scientific answers to the most challenging questions about our bodies. We should all be getting screened for breast cancer every 2 years starting at age 40, but we should also all raise our voices to demand that researchers work as quickly as possible to find out whether there is anything else that women with dense breasts should do to protect their health. We deserve nothing less.
Carol M. Mangione, MD,opens in a new tab or window is immediate past chair of the U.S. Preventive Services Task Force.

"

 

[autumngems]

Mine just came back clear, yay!

 

[pearlsngems]

So, I was told most women's breasts get denser as we age. My facility has been doing the "slicing" type mammography and an automatic ultrasound every year.

Actually the opposite it true. When glandular tissue is no longer needed after menopause, it is more common for breasts to become more fatty / less dense. But something like 1/3 of women who previously had dense breasts still have dense breasts after 65. Dense breasts are at least partly genetic, from what I've read.

 

[missy]

So, I was told most women's breasts get denser as we age. My facility has been doing the "slicing" type mammography and an automatic ultrasound every year.

Actually the opposite it true. When glandular tissue is no longer needed after menopause, it is more common for breasts to become more fatty / less dense. But something like 1/3 of women who previously had dense breasts still have dense breasts after 65. Dense breasts are at least partly genetic, from what I've read.

Yup. Breast density is often genetic but other factors like having children and/or going through menopause and/or using hormone replacements can change the density of breast tissue. Younger women typically have more dense breasts. Hormonal changes associated with menopause can make breast tissue more fatty. Lucky me my breasts are still super dense and show no sign of letting that go lol

Dense breast tissue may increase the risk of breast cancer

Find out what it means if your mammogram report says you have dense breast tissue. Learn about additional breast cancer screening tests to consider.

www.mayoclinic.org

 

[missy]

"

https://www.nejm.org/doi/full/10.1056/NEJMp2307229?query=TOC&cid=NEJM+eToc%2C+September+21%2C+2023+DM2285141_NEJM_Non_Subscriber&bid=1808716758

Perspective

The New USPSTF Mammography Recommendations — A Dissenting View​

List of authors.

• Steven Woloshin, M.D.,
• Karsten Juhl Jørgensen, M.D., D.Med.Sci.,
• Shelley Hwang, M.D., M.P.H.,
• and H. Gilbert Welch, M.D., M.P.H.

• Article​
• Figures/Media​

Metrics​

• 5 References

​

Audio Interview​

Interview with Steven Woloshin on an updated U.S. Preventive Services Task Force recommendation regarding the starting age for mammography screening. (06:33)Download

​

Recently, the U.S. Preventive Services Task Force (USPSTF) changed its recommendation for the starting age for mammography screening from 50 to 40 years.1 Previously, the Task Force deemed screening in 40-to-50-year-old women a personal choice. Because USPSTF recommendations are so influential, mammography screening for women in their 40s will probably become a health care performance measure; if so, it will effectively become a public health imperative with which primary care practitioners must comply. Such a change will affect more than 20 million U.S. women, and it raises some important questions.

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Breast-Cancer Mortality Trends in Four Countries with Varied Screening Practices.

First, is there new evidence that mortality from breast cancer is increasing? To the contrary, there has been a steady decrease in breast-cancer mortality in the United States — a major success story of modern medicine. The reduction has been most pronounced among women under 50, whose breast-cancer mortality has been cut in half over the past 30 years, according to the National Vital Statistics System. Similar patterns are seen in other high-income countries, including both those where screening of women in their 40s is very rare (Denmark and the United Kingdom) and those where screening is rare in all age groups (Switzerland) — which suggests that the decline has resulted largely from improved treatment, not screening (see graphs).

Second, is there new evidence that the benefit of mammography is increasing? Since the previous USPSTF recommendation was made, there have been no new randomized trials of screening mammography for women in their 40s. Eight randomized trials for this age group, including the most recent (the U.K. Age trial), revealed no significant effect.2 This finding reflects both the rarity of death related to breast cancer among women in their 40s and the fact that screening reduces mortality less than was hoped — perhaps because more aggressive disease occurs in this age group. Fast-growing cancers are more likely to be missed by screening, often appearing in the interval between exams.

Instead of new trial data, the new recommendation is based on statistical models that estimate what might happen if the starting age were lowered. The models assume that screening mammography reduces breast-cancer mortality by about 25% and conclude that screening 1000 women from 40 to 74 years of age, instead of 50 to 74, would result in one to two fewer breast-cancer deaths over a lifetime.

The USPSTF’s increasing reliance on complex statistical modeling is problematic. Estimated effects can be extremely sensitive to modeling assumptions, which often reflect the conventional wisdom at the time. One prominent model, conducted before the Women’s Health Initiative study, projected that nearly all postmenopausal women would have their life expectancy increased by hormone replacement therapy. Models may have the appeal of apparent quantitative precision, but they are only as reliable as their input data and assumptions. As others have argued, policymakers should use models only if they understand the parameters and assumptions underlying them.3

In this case, it is particularly problematic that the modeled 25% relative risk reduction in breast-cancer mortality with mammographic screening exceeds that observed in meta-analyses of the randomized trials: a 16% relative risk reduction for all eight trials combined (95% confidence interval [CI], 27% to 4% reduction) and a 13% relative risk reduction in the three trials with low risk of bias (95% CI, 27% reduction to 3% increase).2

Benefits and Harms of Biennial Screening Mammography for U.S. Women in Their 40s in Terms of the Absolute Risk of Various Outcomes in the Next 10 Years.

So does the balance of benefits and harms support a new public health imperative? Relative risk reductions can be misleading since they contain no information about absolute risk, which is already low and steadily decreasing for this age group. To clarify the potential effects of the updated guideline in absolute terms, the table summarizes the benefits and harms. For U.S. women in their 40s, the risk of death from any cause in the next 10 years is about 3% regardless of screening. The modeled benefit of mammography is a reduction of a woman’s 10-year risk of death from breast cancer from about 0.3% to about 0.2%, a difference of 0.1 percentage point (one breast-cancer death per 1000 women screened for 10 years). In other words, with screening, the likelihood of not dying from breast cancer in the next 10 years increases from 99.7% to 99.8%.

This effect is small, particularly in light of the potential harms and what seem to be overly optimistic assumptions of benefits. By far the most common outcomes are false alarms: the USPSTF model estimates that 36% of women 40 to 49 years of age will have at least one in a 10-year course of biennial screening. All will require more testing to prove they don’t have cancer; some will undergo multiple tests and face substantial out-of-pocket costs. And some will experience fear: about a third of women describe the experience as “very scary” or “the scariest time of my life.”4

Some 6.6% of women screened will have a false alarm requiring a biopsy. In addition, the USPSTF model estimates that 0.2% will be overdiagnosed and treated for a cancer not destined to cause harm. These harms may be more frequent in practice, since the model’s input from the Breast Cancer Surveillance Consortium probably reflects rates from only high-performing practices. The harms will be more frequent if screening occurs annually rather than biennially, as is the current practice for most U.S. women.

The table captures the critical trade-off for women in their 40s: do the benefits, which will accrue to few women, outweigh the harms that will affect many more? The answer is a value judgment that women should be enabled to make for themselves, rather than having a public health imperative imposed on them by physicians with an incentive to meet a “quality” metric. Given the steadily decreasing mortality over the past 30 years attributable to improved treatments, it’s likely that fewer and fewer women will benefit from screening over time, while more screening will increase the harms.

The Task Force also argues that the new recommendation is an important first step in reducing the disparity between Black and White women in mortality from breast cancer. Although mortality among women in their 40s has fallen roughly by half in both groups since 1990 (see the Supplementary Appendix, available at NEJM.org), the disparity is disturbing and persistent: Black women remain considerably more likely to die from breast cancer than White women (23 vs. 13 deaths per 100,000 women), according to the National Vital Statistics System. But it’s hard to imagine how recommending the same intervention to both groups would reduce the disparity, particularly given that screening rates are already similarly high for Black and White women in their 40s (about 60%, according to the National Center for Health Statistics).

More screening can’t address underlying differences in cancer biology: the incidence of triple-negative breast cancer (which lacks expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2) among Black women is twice that among White women, according to the National Cancer Institute. This subtype is the most aggressive, has the least effective treatments, and is the most likely to be missed by screening.5

Nor would earlier screening address the problems facing poor women, who tend to be disproportionately Black, such as the lower quality of medical services available, delayed follow-up on abnormal scans, delays to treatment, and less use of adjuvant therapy. Indeed, lowering the screening age could actually exacerbate the problems contributing to the disparity — by diverting resources toward expanded screening. We need to do more of what really works: ensure that high-quality treatment is more readily accessible to poor women with breast cancer.

A change in mammography recommendations would be supported if there were evidence that breast-cancer outcomes were worsening or if there were new evidence that screening younger women had clear benefits. In fact, neither condition applies.

We hope that policymakers will reconsider the decision to lower the starting age for mammography screening. The Task Force’s models are insufficient to support a new public health imperative, given the limited benefits and such common and important harms to healthy women. It would be better to allow women to make their own decisions based on their own assessment of the data and their values — and to redirect resources to ensuring that all women with breast cancer receive the best and most equitable treatment possible.

​

Disclosure forms provided by the authors are available at NEJM.org.
This article was published on September 16, 2023, at NEJM.org.

Author Affiliations​

From the Dartmouth Institute and Dartmouth Cancer Center, Lebanon, NH (S.W.); the Lisa Schwartz Foundation for Truth in Medicine, Norwich, VT (S.W., K.J.J., S.H., H.G.W.); Cochrane Denmark and the Center for Evidence-Based Medicine Odense, Department of Clinical Research, University of Southern Denmark, Odense (K.J.J.); the Department of Surgery, Duke University, Durham, NC (S.H.); and the Center for Surgery and Public Health, Department of Surgery, Brigham and Women’s Hospital, Boston (H.G.W.).​

​

Supplementary Material​

[TR]
[TD]Supplementary Appendix[/TD]
[TD]PDF[/TD]
[TD]312KB[/TD]
[/TR]
[TR]
[TD]Disclosure Forms[/TD]
[TD]PDF[/TD]
[TD]349KB[/TD]
[/TR]​

​

References (5)​

"

 

[tyty333]

@missy So it's basically saying there is no marked increase in the prevention of death by doing mamos between the ages of
40-50 y.o . ? Possibly saving 1 per 1000 by starting at 40 instead of 50. It states lots of false positives in that age range and it
would be better to spend the money on other things that have better results.

I'm not in that age range anymore so I'm not really sure how I feel about it. Perhaps only those with a family history of breast
cancer or those who have a higher chance of cancer should get mamos in that age range. ) I know that a lot of people who have
no "family history" do end up with breast cancer though.)

What are your thoughts @missy?

 

[missy]

@missy So it's basically saying there is no marked increase in the prevention of death by doing mamos between the ages of
40-50 y.o . ? Possibly saving 1 per 1000 by starting at 40 instead of 50. It states lots of false positives in that age range and it
would be better to spend the money on other things that have better results.

I'm not in that age range anymore so I'm not really sure how I feel about it. Perhaps only those with a family history of breast
cancer or those who have a higher chance of cancer should get mamos in that age range. ) I know that a lot of people who have
no "family history" do end up with breast cancer though.)

What are your thoughts @missy?

I always say statistics are useless when we are outside that statistic. Insurances play games with our lives to save money. Unconscionable. I know too many friends who got breast cancer and luckily were diagnosed early via mammograms and ultrasounds. I am continuing yearly for both


In my mind if we are that one who ends up getting diagnosed early and having an excellent prognosis due to that early catch it’s worth it. I wont share what I think about the people in bed with the insurances and big pharma too since I’m speaking of corruption. Yeah I’ll spare you the expletives I’d like to share lol

 

[lulu_ma]

I go with my mom to her annual doctor's visit. The doctor, who is excellent otherwise, keeps mentioning to my mom that a mammogram isn't necessary at her age.

Meanwhile, my auntie who is 2 years younger than my mom got diagnosed with breast cancer just 3 years ago. Needless to say, my mom who is 81 will continue to get annual mammograms!

 

[Bonfire]

Younger women are being diagnosed with BC, some as young as 30, much more often than in the past. I think every woman should have access to a baseline mammogram starting at 35. I think doctors should recommend it and insurance should cover it.

 

[mom2dolls]

This is timely for me as well. Dense tissue over here. Had my annual mammogram and they saw two new spots. Going in next Wednesday for an ultrasound and diagnostic mammogram. Not gonna lie, a little unsettled. I always need an ultrasound to check an existing spot and it was always clear but two new little spots are unnerving. Plus my family practioner told me I no longer needed a pap smear since I had a hysterectomy in 2013 for cervical cancer. Well! He was completely wrong. So had that last week as well and waiting on those results. The look on the NP's face when she read my history and we were discussing my not having had an exam for ten years was worrisome. Praying for clear results.

 

[tyty333]

@missy The statistics... that's why I don't know how to feel. If I'm that one in 1000 who could be saved then yes, I want them!

I mistakenly thought that if the money wasn't spent on mamos for 40-50 it might go to breast cancer cure research
instead. Silly me! Of course, it would go into the pockets of insurance companies! Grrr

@lulu_ma My MIL was diagnosed with breast cancer in her seventies. Luckily, it was easily treatable and she lived until 90.

@Bonfire I think a baseline early on is a very good idea.

 

[tyty333]

@mom2dolls Keeping my fingers crossed and sending positive thoughts that the spots are nothing serious. It would be
hard not to be on pins and needles until you have more info. Definitely a nerve-wracking time waiting for results AND
having to do further testing on previous results. {Hugs} We're here for you...