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Why screening mammograms aren't as great as you may think - Frugal Nurse

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waybeyondfedup
Posted (edited)

What do you think about this?    

Here we go again with yet another one with same old why screening for mammograms.  But this is one is more in line with I feel about this.

I for one I all of both of in the middle of the road/waybeyondfedup.

Quote

http://frugalnurse.com/2019/10/screening-mammograms-risk-benefit-theater/

Why screening mammograms aren’t as great as you may think

October 24, 2019

I’m all about high-value, evidence-based healthcare.

And because October is Breast Cancer Awareness month (Think Pink? Think Twice!), I want to share this video by Andrew Lazris, MD, and Erik Rifkin, PhD. They use the visual of 1000 women sitting in a theater to illustrate why screening mammograms probably won’t save your life.

A picture (or video) is worth a thousand words, isn’t it?

The harms of screening mammograms

As mentioned in the video, more women will be harmed by screening mammograms than helped. One life will be saved (which I get is all that matters if it’s your life), but hundreds of women will suffer the pain, side effects, inconvenience, anxiety, and cost of unnecessary surgery.

And despite the aggressive marketing campaign, 3D mammograms may not be any better. But they are definitely more expensive! Not all insurance companies cover them 100% like they do for the standard 2D mammograms—check with your insurance company.

I’ve written many posts about the problems, including high costs, of overscreening and overtreating. Did you know we spend hundreds of billions of dollars every year on unnecessary healthcare?

Shared decision-making

I think there’s too much marketing of screening exams and not enough meaningful education.

“Mammograms save lives” is a great catchphrase, but it certainly doesn’t explain the risks and benefits.

Don’t be pushed into scheduling a mammogram because of an advertisement. Shared decision-making involves talking with your physician about the pros and cons of any test or treatment.

Shared decision-making takes into account your personal health history, your family health history, and your health values or goals.

Ask questions until you really understand the limitations and possible risks; then make a plan that works for YOU.

Different women will make different choices.

I like this video showing how shared decision-making works for screening mammograms.

Finding reliable information

Personally, I don’t think we’re talking enough about screening mammograms. Like so much in medicine now, benefits are hyped and risks are downplayed. Profits matter more than health.

And it really bothers me that other entities are getting in between us and our physicians, and undermining shared decision-making.

Some doctors are financially penalized if their female patients don’t follow the screening mammogram guidelines set out by insurance companies, or some government agency.

Most doctors don’t have the luxury of time to spend on shared decision-making, either. Many are burnt-out and find it easiest to just click the box on the computer screen that says they discussed screening mammograms with the patient.

Sigh. As always, the burden is on the patient to be informed and ask lots of questions.

Here are some sources that I think have reliable information on mammograms and screening guidelines:

The United States Preventive Services Task Force (USPSTF)

The Centers for Disease Control (CDC)

Journal of the American Medical Association (JAMA)

National Institutes of Health (NIH)

Science-Based Medicine (SBM)

Being an informed patient will maximize the chance a screening mammogram will help rather than hurt you.

Check out my Resources page for more links to good evidence-based medicine and shared decision-making websites.

Sláinte,

Frugal Nurse

 

Edited by waybeyondfedup
Joemeza
Posted

Hi, I have just joined and from the UK so insurance aside as we do not pay any. In the UK you have your first mamagram at age 50, I had mine early Aug 2 weeks later I had to go for a biopsy to take some calification from my right breast, the procedure was unpleasant (clamped into a mamagram machine) after 10 mamagrams and ultrasound then a local anasthetic and a needle inserted to do the biopsy. 2 weeks later i went abck for the results and was told i would need to come back so they can remove more as it looks suspect of turning into cancer but at this stage wasnt. Last thur I went back for round 2. It was horrific and traumatic, similar process but much bigger biopsy where a bigger needle is inserted and then once in goes around in a circle taking samples from different areas inside the breast. I had three times the anistetic and I felt everything. The surgery had to be stopped half way through as the needle hit a nerve. I wanted to pull back but I couldn't, my breast was in the vice of a mamagram machine with a needle I see red into my breast. In the past I've had skin cancer and even had a piece of my nose removed. This though was way more traumatic. I was back home an hour after all this happened and have since seen a doctor who as well as giving me pain relief for this gave me 3 weeks off work to recover from the trauma. I don't know yet If they even got enough of what they needed, I hope so because I won't be going through a stereo guided vacuum assisted biopsy Ever Again. I never expected to see this article when I came in here tonight. Hope my experience makes you consider your options too!

waybeyondfedup
Posted (edited)
4 hours ago, Joemeza said:

Hi, I have just joined and from the UK so insurance aside as we do not pay any. In the UK you have your first mamagram at age 50, I had mine early Aug 2 weeks later I had to go for a biopsy to take some calification from my right breast, the procedure was unpleasant (clamped into a mamagram machine) after 10 mamagrams and ultrasound then a local anasthetic and a needle inserted to do the biopsy. 2 weeks later i went abck for the results and was told i would need to come back so they can remove more as it looks suspect of turning into cancer but at this stage wasnt. Last thur I went back for round 2. It was horrific and traumatic, similar process but much bigger biopsy where a bigger needle is inserted and then once in goes around in a circle taking samples from different areas inside the breast. I had three times the anistetic and I felt everything. The surgery had to be stopped half way through as the needle hit a nerve. I wanted to pull back but I couldn't, my breast was in the vice of a mamagram machine with a needle I see red into my breast. In the past I've had skin cancer and even had a piece of my nose removed. This though was way more traumatic. I was back home an hour after all this happened and have since seen a doctor who as well as giving me pain relief for this gave me 3 weeks off work to recover from the trauma. I don't know yet If they even got enough of what they needed, I hope so because I won't be going through a stereo guided vacuum assisted biopsy Ever Again. I never expected to see this article when I came in here tonight. Hope my experience makes you consider your options too!

Hi, @Joemeza,

Welcome to here and for this as well.  WOW, but at the same time recommend that you check out my intro to here.  Its in the intro part of here and also can be fi/ound by clicking into my profile as well.

Edited by waybeyondfedup

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