I haven’t written in awhile on DCIS because I have not seen anything new lately, but recently, a well-publicized article caught my attention. While the article focused on the mammogram debate, it also noted that there is new thinking on the DCIS front.
I looked into this. There is nothing very new, but there is a seeming trend towards reconsidering extreme options for treating DCIS. I read another article in the Baltimore Sun titled Doctors Seek to Scale Back Treatment for Common Breast Cancer Diagnosis, which emphasizes the idea that DCIS rarely causes harm, but it can turn into breast cancer. The author notes that DCIS is sometimes referred to as stage-zero cancer, or pre-cancer, and again, this concept is nothing new. However, the subject of risk came up. Do we want to treat a pre-cancer as radically as a full-blown cancer? Studies are cited, and the article includes quotes from physicians, including Dr. Esserman. It is a good article that visits the nuances of decision-making, and why it is still so difficult to know what to do. But does it really point to a new way of thinking? The short answer is, not really. The topic is still very controversial, but with headlines like this, there is a suggestion that perhaps the community is looking into the difficulty in making decisions for those diagnosed with DCIS. It is a recognition that women aren’t just doing what they’re told. They are thinking about their options.
The article looks at choices, such as the one that Angelina Jolie made. At the time her situation became public, I co-authored a blog post titled Angelina Jolie’s Decision at Everything Noetic on why it was courageous for her to have made that choice. Personally, I would vie for watching and waiting as opposed to taking radical action. Of course, it is easy for me to say. When faced with a 5% chance of breast cancer, I decided to do a surgical, incisional biopsy, a procedure that my doctor assured would have removed the DCIS with clean margins had it turned out to be positive. Truthfully, I don’t know what I would do had things gone a different way. Plus, I didn’t watchfully wait, nor did I do the less invasive stereotactic biopsy. It is hard to know what you would really do in any given situation that has not yet occurred.
When it comes to treating DCIS or a suspicious mammogram, I do not think there are right and wrong answers. I do however hope that future research will support a trend away from aggressive treatment.
I can’t believe it is over a year since I posted. I had my mammogram last week, and going to an excellent facility really makes the process easier. When I arrived, I requested that my x-rays be read while I wait, since I have to travel to get to this better than average women’s center. They were more than happy to oblige, and I only had to wait five minutes while one of the three radiologists read them. So I left without the fear of a callback. Once you’ve had callback, you know that getting a routine screening leaves you a bit uneasy until you get the letter saying that everything is okay.
Also, I was asked if I wanted a 3D mammo and while I have not researched this extensively, I did read that it emits more radiation. The radiation in the standard mammogram troubles me, so I told the technician I will stick with the regular one.
I have not done any additional research on the value of mammography other than to discuss it with my doctor. Although I have concerns about this path, I have not yet been able to find a better solution to the problem of this screening. I just don’t want to take a chance and skip it when all the leading physicians and organizations are in agreement on this one thing. Does it cause unnecessary biopsies and does it fail to catch fast growing cancers? Yes, on both counts. But again, there is no perfect screening and right now, this is the only thing acceptable to my doctors so I will stick with it, but I am certainly open to other ideas.
One thing that might help is to go two years instead of one, according to new research. This way, there will be a reduced amount of radiation, but the routine stays in tact. I did wait 15 months–not 12–to get mine. I generally do push the limits for many screens, knowing that guidelines are probably more stringent than they need to be. That annual breast cancer screening is still the norm is suggested by the fact that the technician mentioned my tardiness and asked if I had trouble getting an appointment. I just told her no. Anyway, I am glad that’s over and I will probably do it again in another 12 or 15 or 24 months.
So I had my mammogram in December. I meant to report this right after I had the exam and now it is March! I am barely blogging with the exception of Everythingnoetic.com, a blog I co-author. (If you are interested in my other projects you can find out by visiting the blog).
What I really liked about the visit is the fact that the mammogram and physician visit was done on the same day. I would highly recommend going to a facility where there is no waiting involved. Facilities that do it all in one day are wonderful and I will continue to go this route.
I will also continue to provide sporadic updates. Obviously, my focus is elsewhere because everything was ok, but I have not forgotten about this blog. Although there is very little interaction, I can tell you that for a blog that is inactive, I continue to get a lot of hits. I really like being able to facilitate the dissemination of information that is so hard to find. Please feel free to comment if you would like me to look into any topic about breast cancer and I will do my best to make time for it. Blessings to anyone who finds themselves here struggling with issues concerning breast health.
Finally, this week, two things came up directly pertaining to breast cancer and I found myself talking about this blog. Yesterday, I went to the Mind-Body-Spirit Expo in NJ and met people from a thermography center. At the booth, they handed out some literature on breast thermography and here is a link to a site with more information on the process. I also posted several links on the page titled LINKS for anyone wanting more information on going the thermography route in NJ. The other thing that came up is that I heard about a book on breast cancer I wanted to check out. If it turns out to be enlightening, I will blog about that next time.
If anyone is using thermography in place of mammograms or in conjunction with them, I’d love to hear what you think about breast cancer screenings!
I just heard the breast cancer story related to the risk that certain women face. Perhaps the majority of women are not affected by this news story, but it should cause us to take notice. Are our annual mammograms really necessary?
That mammograms can be dangerous is something that many professionals have overlooked. This blog is above all about caution and making decisions based on the evidence and not fear. Mammograms do come with risks so when you embrace the mammo as something you ought to do to be labeled a good girl, realize that mammograms are not as safe as doctors claim. We remember DES. Trusting everything the medical community says without research and inquiry is not prudent. You have seen on this blog links to information from many doctors that do not support the mainstream. For example, some doctors recommend thermography instead, and I blogged about that before here.
In my last post, I reported that my next mammo would be in September, which is now, but I found out I am not really “due” until November as I did have one right before my surgery. For someone who has no additional risk of breast cancer, I have had a great deal of mammograms and a breast surgery during the past year, just to be sure. Again, I will accept the radiation in November as I chose to go the conventional route for reasons I explain in this post, but after the follow up visit with the breast surgeon, I will rethink the annual mammogram again. I had a reprieve from decision-making this past year because I had a normal biopsy, but now the routine process begins again.
The new research that questions the safety of the mammogram is alarming. It means that perhaps the radiation has done more harm than good for a select group of women. We really need to be more careful with this type of routine screening. So, are mammograms safe? No, they aren’t. Of course, once again, ignoring the issue is not safe either. Mammograms have saved lives. We need to make decisions individually based on the best information out there. While we should never listen to the conventional advice blindly, that does not mean we should stick our heads in the sand.