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Screening recommendations

Last year, I had a bit of a fight with my healthcare provider over whether I needed a PAP smear to get my birth control prescription refilled.

So I'm intrigued by the outrage and angst over the new recommendations regarding mamography. I'm 36, so I haven't had the boob squishing machine experience yet. And I don't think that I'm going to fight particularly hard to get one for the next 15 years or so, unless I think something is wrong.

I don't have a family history on either side of the family for breast cancer. I don't have any of the risk factors for breast cancer, and I'm very conscious about the utilization of medical resources. (The tool indicates that I have an 8% chance of getting breast cancer in my lifetime, and a 0.03% chance of getting it in the next five years. Interestingly, those numbers increase to 11.3% and 0.04% if I answer that I'm white instead of Hispanic.)

So, unless my doctor convinces me that a mamogram is necessary, I'll forego the experience until I'm 50.

The key here is looking at the general data on breast cancer and applying it to me and my own medical history. If I had a mother, two aunts and a few grandmothers and cousins with breast cancer, then my analysis would be altered. And I recognize that younger women do get breast cancer, well before 50, as I recognize that PAP smears pick up cervical cancers (though they pick up more false positives than real positives)). I have friends who have had breast and cervical cancers in their 30s. And I expect that I'll have more friends who experience cancers in their 40s.

But these screenings, like any other medical intervention, supposed to be tailored to the risks for the individual patient, not the population as a whole. And so it's very possible that the recommendations for the population do not apply to the individuals.



( 3 comments — Say something )
Nov. 18th, 2009 11:01 pm (UTC)
I used the tool and my risk is elevated slightly because of the negative testing I had done earlier this year. I kind of wish I'd waited and had my baseline later, because that was a scary (and resource consuming!) experience and I really feel like it was all for nothing.
Nov. 18th, 2009 11:08 pm (UTC)
My girlfriend the NP says that she'll keep recommending mammograms to under-50 women (because, let's face it, women under 50 get breast cancer too), even if they're not Braca-positive, but that, as you said, those are guidelines, not rules which must be inflexibly applied.
Nov. 19th, 2009 12:25 am (UTC)
Oh sure, they come out with that new rec two months after I have my first boob-squishing. Granted, I had a lump, so I'd have done it anyway, but still. Maybe that means I don't have to have one for another 8 years.
( 3 comments — Say something )