Wednesday, January 30, 2008

Hands Off

Since late 80ies-early 90ies women in Sweden, of a certain age, in a certain age group, have been "invited" to on a regular basis take part in a nationwide mass mammography screening of healthy women. Until now I haven't belong to that age group, and I don't, luckily and touch wood, belong to any risk group, so I haven't given the procedure all that much thought. Yes, until now that is. When I suddenly have stepped over a dreaded threshold and find myself belonging to that particular age group. I'm talking about the age group of the new twenties.

And not only do I belong to that certain age group, now, I also in my letter box found a summon to this mass screening. A screening you have to pay for - certainly a reduced price, and of course I don't mind paying a reasonable sum for a doctor's appointment and medical care. If I myself chose or have to make an appointment that is.

What I really do mind is that you somehow, as a woman, a healthy one, in Sweden, is suppose to be so extremely grateful for being offered this chance of a very painful procedure. A procedure that is *said to* make all the difference when it comes to detecting early stages of breast cancer.

What there's little talk of - and woe the ones that dare to think differently, and actually have reinforcing research to prove their point. Woe the ones that have a different view on the reasonableness of this kind of mass screening - is the research findings that show there are other procedures, less painful, like MRI that have a much higher percentage of detecting the early stages of malignant cellular changes. Whilst the mammography screening apparently has a tendency to miss about 50% of those malignant changes.

Not only that, what are benign tumours fairly often through this mass screening lead to many serious implications such as unnecessary treatment, surgery and suffering for many women. I just can't seem to shake off the feeling of this mass procedure being a very strange web of horror propaganda. For a whole lot of different hidden agendas.

A sad and worrying fact is that the medical attendance, research and treatment of women in the health care realm in general lag the care and treatment men gets. And somehow I don't think it's all that far fetched to mull a bit over the possible scenario that if mammography being a thing when men had to pull out there nuts and have them crushed in a screening machine, I bet they wouldn't be all that grateful for that golden opportunity. I'm rather convinced they'd scream loud and clear demanding other less painful, intimidating and degrading procedures to be established. Right now.

Whilst women are bunched together as a group of moo cows, up for screening. Here's your appointment, stand in fold, pay please, out and up with the breast, crush. Honestly, I think it's not only insulting I also think its a violation of integrity, masked in concern for women health issues.

And those were and are the multiple reasons why I, after thinking it through over and over again, turned this debatable *offer* down. I'm now going to read and learn more about the pros and cons, the alternatives and different views. That I said no this time, doesn't mean I won't change my mind in the future. But in my world, a healthy amount of scepticism is never ever wrong.

I also want to mention that I by no means live in the it-doesn't-happen-to-me-illusion. Awful, horrible, tragic things happen to most everyone. Lightning strikes. Things fall from out of the blue above. Most accidents happen in the home. And so forth. I'm probably no more imperishable than my neighbour - well, perhaps two or three of them, but...

I do have friends and acquaintances who have had both chemotherapy and mastectomy due to breast cancer. So yes, things happen. Terrible, devastating, overturning events. However, that doesn't mean I have to concur with the seemingly well-meaning mass herding of women and their body parts into a questionable procedure. Moo.


heidikins said...

I like this post, very opinionated and well written.

I happen to be in a high risk group (damn those genetics!) and get a screening every year, and have since I was 17. It's not my favorite day of the year, but due to my DNA I'm more than willing to be squashed every now and then.

Great post.

Pia K said...


Oh, I'm so sorry to hear about them, in this case, not so fortunate DNA-part. And that makes me even more upset, there must be other procedures, less crushing, less humiliating - even though I suppose that's a personal view - and with better results. Granted I'm a layman, but what about bloodtests for example? IMHO I fail to see why, if you in many cases can detect certain gene/s, then why shouldn't you be able to also detect malignant cell changes with that...

Beverly Cody said...

upright mri

Anonymous said...

I agree with you. You are not alone with these thoughts. Diagnostic radiation is not benign either.
There I am certain alternative ways of detection.

Pia K said...

I'm glad I'm not alone with the thoughts, overall there's a very strange lack of discussion around this - and many other - issues...

Poppy Q said...

Hi Pia,
I can offer a little insight because I work in the x-ray department. Mammograms use probably the lowest level of radiation, and at such low doses annual or bi-annual mammograms offer little risk due to the x-rays used. Although MRI is an extremely useful test, it is often long (about 45 minutes in our department), uncomfortable, claustrophobic and needs the use of a MRI contrast agentinjection to show more detail. A fantastic test, but often better used in conjuction with a mammogram. Upright MRI is not an option, as it has much less sensitivity than a standard MRI.

Although uncomforatble, during a mammogram the breast is only compressed as short a time as possible, this gives a flatter clearer image, giving the doctors the best view. I am sure we all wear uncomfortable shoes for longer periods, in order to look good.

Breasts change as we age. While we are younger and perkier they are dense and it may be difficult to interprut any changes before the age of forty. Over forty the breast tissue becomes less dense and more fatty making mammos more useful. They are never going to be 100% perfect in finding every cancer, but they are the best we have at the moment. By starting early, doctors are able to detect any changes early - and early is best.

I am approaching the age, and not looking forward to mine either - even knowing what I know. But, I'll do it. Who would look after Poppy?

A blood test checking DNA may be able to detect genes that may indicate you are higher risk of breast cancer, but they are unable to show that your breasts are healthy or that you have any cancerous changes.

I scanned a woman this week, 4o ish with a newborn first child. Her lump was found when she started breastfeeding, and is very agreesive and has spread rapidly giving her a slim chance of survival.

I want to give myself every chance, every day is bonus. Good on you for investigating all of the options, it is always a good thing to be informed and educated.This is a good page from New Zealands breast screening programme

Have a great weekend.
Julie and poppy Q

Pia K said...

Wow, thanks for that input, Julie! Very interesting read!

A great weekend to you too:)

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