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Topic: Is a mammogram a good idea?  (Read 3979 times)

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Re: Is a mammogram a good idea?
« Reply #15 on: November 29, 2006, 03:52:21 PM »
i really feel for all the people on this thread who had had cancer, or someone close to them have. 

but something i'd like to point out as sensitively as possible- is that the NHS is a rationalized service.  on the whole, and in my experience, they are much more selective in what treatments are part of the service.  for example- in the US when i got blood drawn every year for my thyroid test- they'd also test for cholestrol, sugars, cbc, etc.  machine gun approach.  in the UK when i get a thyroid test- i get JUST that- more of a sharpshooter approach.  in the US women who are insured get pap smears every year or so.  note how i said INSURED.  in teh UK all women get pap smears every 3 years, and more often if there's a clinicial need.  both methododolgy have their benefits- is it better to test for lots of things in the hope of picking something up, is it better to save money for other's people's tests.

the US health system is also much more consumer orientated.  you're the patient, client, consumer.  you want this, you demand this, you find a dr who will do it. 

the UK system is more (in theory at least) apt to look at the good of society- is it better to offer a cheaper treatment to lots of people or a more expensive treatment to fewer people. 

now.....
with all that said- in the UK I have found that if you push a bit... you can get results.

as for people moving to the UK-  if you are concerned about the UK health system, if you like the HMO like system the US has, buy supplemental insurance.  not 100% the same, but you can see specialists quicker, many have options of getting screened quicker etc...

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Re: Is a mammogram a good idea?
« Reply #16 on: November 29, 2006, 03:54:27 PM »
thanks, katadina, for sharing your story and letting us know that diagnosis is not a death sentence. it's people like you--and my gram--that give the rest of us hope. :)
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Re: Is a mammogram a good idea?
« Reply #17 on: November 29, 2006, 03:55:33 PM »
i really feel for all the people on this thread who had had cancer, or someone close to them have. 

but something i'd like to point out as sensitively as possible- is that the NHS is a rationalized service.  on the whole, and in my experience, they are much more selective in what treatments are part of the service.  for example- in the US when i got blood drawn every year for my thyroid test- they'd also test for cholestrol, sugars, cbc, etc.  machine gun approach.  in the UK when i get a thyroid test- i get JUST that- more of a sharpshooter approach.  in the US women who are insured get pap smears every year or so.  note how i said INSURED.  in teh UK all women get pap smears every 3 years, and more often if there's a clinicial need.  both methododolgy have their benefits- is it better to test for lots of things in the hope of picking something up, is it better to save money for other's people's tests.

the US health system is also much more consumer orientated.  you're the patient, client, consumer.  you want this, you demand this, you find a dr who will do it. 

the UK system is more (in theory at least) apt to look at the good of society- is it better to offer a cheaper treatment to lots of people or a more expensive treatment to fewer people. 

now.....
with all that said- in the UK I have found that if you push a bit... you can get results.

as for people moving to the UK-  if you are concerned about the UK health system, if you like the HMO like system the US has, buy supplemental insurance.  not 100% the same, but you can see specialists quicker, many have options of getting screened quicker etc...



good points, meggles.
it's not where you're born, it's where you belong

-U2, 'summer rain'


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Re: mammogram responces to all of you
« Reply #18 on: November 29, 2006, 04:00:32 PM »
Chary are you in England now? Because if you are in the US, find another doctor, that dr was is an idiot. Im sorry to offend but with a family history they need to be proactive and if they arent, you arent getting good care and that is not fair to you. If you are in england find a doctor, explain the amount of cancer and do all you can to get a mammogram done. With your family history they should have no problems with it.

I'm in Wales, not England. But I'm over 40 and had a mammogram in the US at 40. Seriously, though, 40 is the standard age, unless there's breast cancer in the immediate family. My doctor was not an idiot.
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Re: Is a mammogram a good idea?
« Reply #19 on: November 29, 2006, 04:13:03 PM »
Meg

Thank you, I really agree with your post. I think anyone moving to the UK has to know that you have some of the most phenomenal scientists and doctors in the UK. The BRAC genes to detect genetic breast cancer were found by UK scientists.

No system is perfect, my breast surgeon woke me up after removing both of my breasts to tell me he left something in my chest in the form of a plastic thing and needed to pull me back into surgery to remove it. You can imagine my mental state that day but what was I going to do?

The US has been criticized by many for doing unnecessary mastectomies and unnecessary rounds of chemo. If you aren't aware of chemo kills more than just the cancer cells and sadly they don't tell you some of the ramifications of high levels of chemo. In the US they will justify it by saying that they are trying to get microscopic cells that could be floating around in your bloodstream before they turn into a mass. And when you're sitting there all you want is to never have a chance of cancer again so you do it.

My mother-in-law didn't have chemo in the UK, they felt it was unnecessary. She is now nine years out and doing very well and I am four years out and I'm still struggling with a lot of health problems from the chemo.

I also need to say that most families in America are just one major health crisis away from bankruptcy. Not every family is insured and they should be and those that are insured with what is considered pretty good health insurance could lose everything with one bout of cancer.

Bottom line is I can't afford to die in my own country. If I get sick again I lose everything and my family will suffer severely. And we have wonderful health insurance but not good enough. It took me four years and refinancing my house to pay off all my medical bills from cancer.

Again you all know I'm passionate about this so my posts are long. At the end of the day we all have to do what works for us you have to be your own advocate of the grass is not greener on the other side. Both systems are not perfect and both systems have their faults.





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Re: Is a mammogram a good idea?
« Reply #20 on: November 29, 2006, 04:17:03 PM »
I'm in Wales, not England. But I'm over 40 and had a mammogram in the US at 40. Seriously, though, 40 is the standard age, unless there's breast cancer in the immediate family. My doctor was not an idiot.


Chary,


I do apologize for offending you, there is really no excuse for what I said barring my own life experiences and the deep passion I have for people. When you said that breast cancer ran and your family and there was a whole lot of it although I didn't know you I felt the need to be an advocate for you.

I am sorry for calling your doctor and idiot. The standard is 40 years old unless there is breast cancer in the family or you have a history of cysts or health problems. I was under the impression that your history was a lot worse than it sounds like it is. But still that is no excuse for my behavior and I apologize. I did not want to offend you, I know I can be overzealous at times and I get very defensive when women are treated the way they need to be.

I hope you can accept my apology.
Kath




Re: Is a mammogram a good idea?
« Reply #21 on: November 29, 2006, 04:29:28 PM »
Some of the guidelines that the NHS sets forward are just stupid.  Pap smears every 3 years? 

Absolutely!  Especially how cheap smear tests are, and how effective they are for finding abnormal cells long before they're anything but - when they are cheaply and effectively treated.

'Oh, but if you have two normal ones in a row, there's no need to have a smear test every year . . . '

I cringe to imagine what the future would have held for me had I gone 3 years w/o one. 

I had eleven normal smears in a row.

The 12th one, when I was 30, caught moderate displasia/CINII.


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Re: Is a mammogram a good idea?
« Reply #22 on: November 29, 2006, 04:35:59 PM »
The guidelines for Paps in the US was changed based on recent research to every three years for women over a certain age with a history of normal smears.  I asked my doctor here how often they do Pap smears here and we discussed the difference - she said that she'd be glad to give me one a year, but I'd have to pay for them. 

Also, with the teeth cleaning thing, can't you pay to have them cleaned every six months?  Or are you just talking about NHS dentists? 

I'm probably biased about these things, because I had the worst health insurance in the world in the US, but just because something is free doesn't mean it's neccessary worth your time.  I have prioritized things like paying for my healthcare over eating out once a week or buying new clothes regularly and, while I know that not everyone has the money to make that choice, if you do I personally feel that you should realized it is your choice. 

Back to the OP - What do you think the downsides of having the mammogram are?  Radiation exposure and things like that?
« Last Edit: November 29, 2006, 04:37:38 PM by Carrie »


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Re: Is a mammogram a good idea?
« Reply #23 on: November 29, 2006, 04:49:20 PM »
I hope you can accept my apology.
Kath

Don't be silly, Kath! There's absolutely no need to apologise!  :)
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Re: Is a mammogram a good idea?
« Reply #24 on: November 29, 2006, 05:16:18 PM »
i read last year of a new laser type breast scan that they do recommend starting at 35, to get a baseline reading and track future changes. i think it's standard in the US by now, but not available in the UK. my private doc here said that it is too expensive for the NHS to bring in.....


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Re: Is a mammogram a good idea?
« Reply #25 on: November 29, 2006, 05:37:58 PM »
Also, with the teeth cleaning thing, can't you pay to have them cleaned every six months?  Or are you just talking about NHS dentists? 

NHS dentist - since that's what I've got! 

I'm probably biased about these things, because I had the worst health insurance in the world in the US, but just because something is free doesn't mean it's neccessary worth your time.  I have prioritized things like paying for my healthcare over eating out once a week or buying new clothes regularly and, while I know that not everyone has the money to make that choice, if you do I personally feel that you should realized it is your choice. 

I've only had health insurance for two years out of the past ten.  I've still managed to get my teeth cleaned every six months or so, with two exceptions (one 1.5 years stretch and another 2 year one, which ended shortly after I moved here and registered with the NHS),  thanks to reduced-price dental clinics staffed by dental school students.  I've also managed to get annual exams and pap smears, thanks to the sliding rates at various local health departments and Planned Parenthood.  None of these things have been free, but they've definitely been worth my time *and* my money. Like you, I've made my healthcare, as limited as it is, my priority - which is why I don't have a problem going elsewhere for treatment, like making sure that I get to Planned Parenthood for an exam and a smear during the years when the NHS deems it "unnecessary." 

I've had two abnormal smears in the past five years, as well as one colposcopy, and I have PCOS as well as a history of several different cancers in the family (aunts, uncles and grandparents).  Despite these facts, my GP still insists that one smear every three years is good enough.  No, thank you - if my GP won't take care of my health, I'll take care of it myself.  :P


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Re: Is a mammogram a good idea?
« Reply #26 on: November 29, 2006, 08:41:30 PM »
Absolutely!  Especially how cheap smear tests are, and how effective they are for finding abnormal cells long before they're anything but - when they are cheaply and effectively treated.

'Oh, but if you have two normal ones in a row, there's no need to have a smear test every year . . . '

I cringe to imagine what the future would have held for me had I gone 3 years w/o one. 

I had eleven normal smears in a row.

The 12th one, when I was 30, caught moderate displasia/CINII.

Sometimes pap smears don't even catch cancerous cells.  My mother had a pap smear and her doctor recommended she get the new test (I think its with a black light or something like that).  Insurance didn't cover it, but she paid for it anyway.  Lucky thing she got it because her pap smear came back normal, but the other test didn't.  She had to have two surgeries to get rid of the cancerous cells.
I can't imagine what would of happened if she didn't catch it.


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Re: Is a mammogram a good idea?
« Reply #27 on: November 29, 2006, 11:05:34 PM »
Mammograms in young women are incredibly iffy.  Do you have a family history or a lump?  If no, then I wouldn't.  Younger women have very dense breasts which make mammograms practically useless.  The other issue, is the possibility of false positives, this is a HUGE issue in terms of mammograms and in fact Slate just did an article about this.  In the end, it is your choice, and just for the record I have had a lump that was being "monitored" in the U.S. (no insurance, in fact the Cancer Society never even payed for my mammogram last fall as they were supposed to and now they are threatening me with collections weeeeee). 

But in general, they don't do mammograms on younger women because they aren't very useful.  Ultrasounds on the other are more so, but they only do those if there is an issue.

http://www.slate.com/id/2154563/

Studies also routinely show that mammograms reduce breast-cancer deaths. But that's not really what people care about. What they want is an overall lower death rate. What good, after all, is a test that may lower the risk of lung-cancer death but increase the overall risk of death from side effects, such as pointless operations (as in neuroblastoma)?

Unfortunately, according to the Dartmouth analysis, none of the studies demonstrated any measurable overall reduction in mortality from cancer screening. Most worrisome, in half the studies, the overall mortality rates tended to be worse in screened groups than in unscreened groups—erasing any benefit of screening.



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Re: Is a mammogram a good idea?
« Reply #28 on: November 30, 2006, 01:17:43 AM »
Mammograms in young women are incredibly iffy.  Do you have a family history or a lump?  If no, then I wouldn't.  Younger women have very dense breasts which make mammograms practically useless.  The other issue, is the possibility of false positives, this is a HUGE issue in terms of mammograms and in fact Slate just did an article about this.


Funny you should mention Slate, a different Slate article is what prompted my concerns about getting a mammogram in the first place. The arguments to get one are very convincing, but Slate raised some good points to. Here's the link and the text of the article below:

http://www.motherjones.com/news/feature/1994/05/paulsen.html
 
From Slate:

 Until recently, the medical establishment recommended regular "baseline" or "screening" mammograms for women in their 40s. But increasingly researchers suspect that unless you are over 50 or have found a suspicious lump in your breast, screening mammograms are unnecessary and could possibly increase your breast cancer risk slightly.

Here are four reasons for premenopausal women to think twice before getting a mammogram:

Mammograms don't work very well for premenopausal women.
    Routine mammograms missed 40 percent of the breast cancers that developed among 25,000 women aged 40 to 49, according to a Canadian study released in 1992. In a similar Swedish study, 38 percent were missed. These high rates of false negatives occur because the dense, healthy breast tissue of younger women can resemble or obscure tumors. As a result, mammograms are notoriously inaccurate in women younger than 50, the average age of menopause.
Screening mammograms don't improve your chances of survival.
    The aforementioned Canadian study followed 25,000 women who had routine screening mammograms and an equal number who did not. The findings: Women in both groups developed and died of breast cancer at the same rates. Seven other randomized studies have also reported no statistically significant reduction in the death rates of women who underwent routine screening mammography.
Mammograms sometimes find tumors that aren't there.
    Radiologists are reluctant to rule out malignancy in the case of difficult-to-read areas. False positives occurred in 3 percent of the mammograms reviewed by the Swedish study. False positives usually lead to biopsies which, although relatively safe surgical procedures, are both emotionally and financially draining.
Mammograms expose women to radiation that may cause breast cancer.
    Although modern mammography equipment uses far smaller dosages of radiation than did the machines built during the 1970s, no minimum dose of radiation has been proven safe with respect to breast cancer. "Every dose, no matter how low, confers some risk," says Dr. John Gofman, a nuclear scientist whose work dates back to the Manhattan Project. The risk is believed to be small--Gofman estimates that for a 40-year-old woman, a typical mammogram translates into no more than a 1-in-2,700 chance of developing breast cancer. But this risk is cumulative, increasing with each subsequent mammogram.

The National Cancer Institute, which launched the mammography crusade in the 1970s, recently rescinded its long-standing recommendation that women younger than 50 have routine mammograms. The National Women's Health Network and the Center for Medical Consumers actively advise premenopausal women to avoid mammography except to evaluate suspicious lumps. All three organizations continue to support routine mammography for women over 50.



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Re: Is a mammogram a good idea?
« Reply #29 on: November 30, 2006, 07:23:58 AM »
I just went in for an annual exam, and my doc said annual mammograms are recommended for women age 35 and up. I'm 36. I'm still in the states, this is covered completely by insurance. She was not suggesting that I needed the test based on any family history or an abnormal finding of any kind.

I looked into online, though, and have seen some things about possible bad effects of the test, and have also seen that it's not really needed in women until they are in their 40s or 50s. Any thoughts?

If you have small and/or firm breasts or if you have naturally lumpy (cystic) breasts like I do (actually I have all three - small, very firm and cystic!) then a mammogram may not be your best bet. I noticed you are in the states. Not certain if this procedure is available in the UK yet. Probably, but you might have to pay for it yourself. It is called breast thermography or digital infrared imaging. It is radiation free and your breasts aren't squeezed like with a traditional mammogram. Readings are taken with a heat-sensitive camera. Apparently, it is actually must more effective in the hands of an experienced person as problems can be seen months, if not years, before the cancer has a chance to really develop. The cancer has to be much larger to be detected through a typical mammogram. I haven't done this yet, but am planning to. Apparently, you get a reading - a baseline reading, and then get another one in 6 months as comparison. Then once every year or two if you're over 40.

Here's a good site that explains what it is and why its different from a traditional mammogram. http://www.breastthermography.com/breast_thermography_mf.htm
« Last Edit: November 30, 2006, 07:28:14 AM by alchemist »


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