Whenever I schedule mine, I’m always asked if I have implants.
Sorry, I phrased that badly. I know it’s an x-ray, I was wondering what is was specifically about breasts that they need to be flattened to be x-rayed when they don’t have to flatten other body parts to do x-rays. If female breast tissue is “dense”, is male breast tissue also? For instance, if a guy is a body builder, are his pecs denser tissue than his biceps?
FWIW, every woman I have ever spoken to about this dreads getting mammograms. Wife, old girlfriends, friends, family - they all hate them. My family seems to have avoided the cancer gene (crosses fingers), nobody on either side has had cancer that I am aware of. Even so, none of my sisters would miss a mammogram appointment. Just not worth taking the chance, no matter how small.
I think it’s more a matter of things like tumors or cysts not being as compressible as healthy breast tissue.
We’ve covered this already - apparently there’s never too little to “clamp and squeeze”. This is a link to a gent getting a mammogram.
Yes, because breast tissue isn’t just fat, there’s a bunch of glands in there, too. After menopause these glands atrophy and shrink which, apparently, makes figuring out what’s going on in an x-ray easier. In other words, fat isn’t the problem.
Yeah, it does vary. I suspect the tech has something to do with it.
They’re not “necessary” in the sense that no medical screening is necessary. However, one in nine women (or something like that) will get breast cancer in her lifetime, and that includes a significant number of women who are low risk. Heck, men get breast cancer, too, and they’re at even lower risk than women are.
No one is going to put a gun to your head to force you to get a mammogram. However, it is one of the more reliable ways to get information about what’s going on in a breast and it can detect cancer a lot earlier than your fingers. If you rely on self-exam you’re taking the risk that if cancer occurs it will be found later than it might have been with a mammogram, which is going to increase the amount of stuff that you have to endure if you opt for treating it, with more risk of an early death.
That said, there are situations where mammograms are pointless. My oldest sister (who is also an MD, by the way) has decided she’s not getting them any more because her heart problems are bad enough now that she would never survive treatment for cancer. The only option she would have anyway is palliative care, so in that sense it doesn’t matter whether it’s detected early or late, it would be the same course of treatment (or lack of it, because standard cancer treatment would kill her faster than cancer would) so there’s no point to such a test.
That’s also why at a certain point mammograms are stopped. They’re recommended for women with a life expectancy of 10 years or more. If you’re unlikely to be around in three years there isn’t much point to the screening. If you’re 103 you’d likely not survive chemo/radiation and are probably a poor risk for any sort of surgery so there’s no point to finding out early you’ve got a tumor that can’t be effectively treated anyway.
But most women don’t fall into that category. If you’re healthy and will probably live 10 more years then they’re recommended. Actually they’re so firmly recommended it borders on harassment (or so it feels).
The article you linked to mentions cancer that would never be harmful to the women which sounds contradictory but is a thing. I’m assuming they’re talking about ductal carcinoma in situ which are abnormal cells that may or may not ever become invasive cancer. Usually they don’t, but for decades it’s been treated as cancer which means mastectomies and radiation (not usually chemo, apparently) when in fact the majority of these never become invasive and in that sense would never need to be treated. The problem is that we can’t tell which instances of DCIS are harmless enough to be left alone and which will become deadly.
It’s a bit like prostate cancer in men - if a man lives long enough he’ll almost certainly get this, but most old men die with prostate cancer, not OF prostate cancer. The trick is to try to find out which actually need treatment and which can be left alone.
Some people with DCIS opt for “watchful waiting” but I haven’t heard of any solid research on that, likely because for decades the answer to finding this was cut it out, cut it out, cut it all out.
No, they get pretty damn high on me, too. And also way under the armpit, it’s surprising how far under the arm they want to go. It’s not just pain threshold, I suspect things like how tolerant your skin/muscle/etc are to stretching and such are also a factor. I hear about women getting bruises, too, but that’s never happened to me - on the other hand, I’ve never bruised easily, some people do.
Definitely.
Yeah, cool like all medical rooms seem to be. The first place I went to was Unrelenting Pink in decor. As it happens, I loathe pink due to some childhood experiences. I don’t know, maybe a lot of women find it soothing or something but I found it very off-putting. The place I went to for my last couple of “titty-squeezings” (I have a friend who calls it that) is more typical clinical with a full range of Dull Corporate Palette decor, a very business like atmosphere, which I prefer.
You’d think that with a soft squishy thing, it would be easy to fold it around a probe and let the probe scan it around itself.
Ladies, take your boob in your hand. Bend your index finger so it pokes your boob gently rigth next to your nipple and in the direction of your breast bone. Try to bring your fingertip as close to your breastbone as you can, and to fold as much of your boob around your finger as you can.
Now, how thick is the tissue layer around your finger, at its widest? I bet it is narrower then between those plates.
I have no tumors or cysts. At least, none that’s been seen on a mammogram. Still hurts. I still get bruised.
No, we can’t. But what the article claims is that better studies show that regular mammograms lead to:
- Finding more tumors
- Treating more tumors
- No decrease in mortality, either from tumors or in total
If true, what that means is that waiting to treat until you can feel the tumor doesn’t increase your risk of death.
I will give a made up example, because it’s easier to understand the argument with an example:
Assume we have 100 women. 10 have tumors that can be detected by a mammogram but not by a manual exam. Of those, 5 will grow so slowly that if not detected, the woman will die with them, having never been troubled by them. The other five are more aggressive, and will eventually kill the woman without treatment. In fact, with no treatment, they will kill their host in 7 years.
If they have mammograms, all 10 tumors will be detected and treated. One woman will die anyway, in 7 years.
If they don’t have mammograms, 5 if those women will learn about their tumors 3 years later, when they have grown enough to be felt. Those 5 tumors will be treated, but one woman will die anyway, in 4 years.
So, if we just look at “survival from diagnosis”, mammograms look great. The mortality is only 1 in 10, rather than 1 in 5. And the survival time for that one woman who dies anyway is 7 years, not 4.
But if we look at the population, in both groups, one woman died 7 years after we started following them. But the group with mammograms had 10 surgeries and 10 radiation treatments, whereas the no-mammogram group had only 5 people subjected to that. So the group without mammograms fared better.
That’s a made up example. But that’s approximately what the “mammograms don’t help, and lead to over-diagnosis” people believe is happening.
And the treatment isn’t benign, even ignoring the time and cost and discomfort of it. A woman I used to hang out with died recently, of heart damage from the radiation treatment she had several years ago to treat breast cancer. If the breast cancer would have killed you first, it’s worth it. If it would have sat quietly and never bothered you, it’s not worth it.
I have dense breasts and have been getting 3D mammograms for years. They are pretty much the same in terms of squish. Also, I get the machine with larger plates back before 3D was an option.
What I find strangest about them is not the pain (they are painful, but I don’t leave bruised), but the posing you go through. You are standing there with your breast out, and the tech is "drape this arm here. Put this arm here. Put this foot behind here. Turn slightly this way. Its like posing for a sculpture. Then squish and “don’t move! Don’t breathe!” Then “done!” And again another half dozen times.
Yes, I’ve heard that before. There are a lot of factors that go into this things, not the least of which is that most breast cancers occur in older women. Given the survival rates and life expectancy in many ways it makes no sense to tell women who are, say, 85 to get mammograms - such a woman has an average life expectancy of about 5 years (falls within "only useful for women with a life expectancy of 10 years or greater) and is likely to have other health problems that would bar her receiving aggressive cancer treatment. Time of diagnosis will not affect the outcome.
Where mammograms are most effective are in younger women who can withstand cancer treatments and have the most potential to gain meaningful years from such treatment. Also in women who, due to genetics, are at higher risk of such cancer - some of whom may benefit from prophylactic treatments such as removal of breasts and ovaries after any desired child-bearing although that’s pretty extreme and controversial as well.
DCIS is probably the form of cancer that is most over treated, and that’s why I mentioned it. That doesn’t rule out over-treatment in other cases.
You are also correct in point out the how early diagnosis can alter the “time of survival” and make it appear that treatment is more effective than it actually is. That’s an issue with a lot of cancers that can be detected early. Over treatment is also an issue with prostate cancer with a lot of damage done to a lot of men over the years.
About the only cancer where I’d be willing to say early diagnosis and treatment definitely makes a real difference would be skin cancer… which has the advantage of being easily spotted with the naked eye in many cases and can be removed at early stages without causing severe debility. It’s a hell of a lot easier to remove a malignant spot on the surface of your arm than to dig into your breast to remove a same-sized spot of DCIS.
What we really need is a way to distinguish between cancers that localized and not migrating or aggressive and thus can be left alone, and cancers that really do need immediate attention or otherwise they’ll kill you quickly but we actually CAN do something meaningful you, and finally cancers that we can’t fix that will kill you soon so you can opt for maximum quality of life over length (because cancer treatments can be horrible and can potentially kill you outright) and you can get your affairs in order/take that bucket list trip/whatever. IMO, of course. YMMV.
Again, we don’t have a way to distinguish between those two cancers.
I’m not always sure patients are truly informed of the risks vs. benefits of various treatments, including the actual benefits vs. risks of clinical trials.
Certainly, I don’t think people are truly informed about the risks vs. benefits of various screening tests.
If a woman lives 15 or 20 years past chemo or radiation for an invasive breast cancer I’m guessing it was worth it, because an untreated invasive/aggressive cancer that is not treated will, I assume, kill you a lot sooner than that.
Most cases aren’t so clear cut.
There are all sorts of issues about severely ill parents of young children as well, about social pressures in making decisions, and a bunch of other stuff that can go off in so many different directions.
The ideal medical test would be something with zero risk that gives useful information with 100% accuracy. I don’t think we actually have any medical tests meeting those exact criteria. A mammogram is certainly less invasive and damaging than a biopsy, but from a standpoint of “is this cancer and if so what type?” is not nearly as accurate, either. Neither one is fun, that’s for sure. Either one could miss a cancer as well, so a negative result is not a guarantee (which is why screening is recommended annually rather than one and done).
The only thing I do know for sure is that the average person really doesn’t understand medical testing, and doesn’t really understand a lot of medical stuff. Heck, I’m more knowledgeable than the average lay person and I sure as hell don’t understand a lot of this, not to the point that if any of this came up in my personal life I could make a meaningful decision without additional research and consultation with people more knowledgeable than myself.
I think doctors consider the biggest win to be colon cancer. Many pre-cancerous polyps can be snipped out during a routine colonoscopy, and the only additional treatment needed is increased monitoring for new polyps, since people who grow one tend to grow more.
But of course, screening your skin visually for skin cancer is an extremely low-risk procedure. 
Yes – but we don’t KNOW whether that cancer was invasive.
Honestly, I’m surprised we don’t have better genetic testing of breast cancer biopsies to give us more information. My guess is that a biopsy removes all of a DCIS, and if a genetic test could determine that it was at low risk to become aggressive, one of the “treatment options” could be “wait and see”.
Actually, invasive cancer, by definition, invades other tissues. It’s the stuff sitting in one place that looks like it’s not inclined to do anything more that we just don’t know about. Is it OK to leave it there, or will it start going on a rampage next Tuesday?
And no, a biopsy doesn’t necessarily remove ALL of DCIS. You can have extensive DCIS in multiple milk ducts that is still sitting inside the milk ducts. Is any of that going to be a problem or not? How many biopsies are you going to do on one breast? At which point does it make more sense just to do a mastectomy? (And if you do a mastectomy or lumpectomy do you move to a “wait-and-see” approach or get more aggressive?)
There is certainly research on the genetics of breast cancer, but we don’t have definite answers on any of it yet. The knowledge has affected both treatment options (with some mutations we know the cancer is more or less vulnerable to particular treatments) and prognosis (in some cases we know there isn’t much we have that is effective, unfortunately).
I sometimes think that there is too much emphasis on mammograms, as if they’re a magic preventive, or if a mammogram will jump start your “fight” against the disease, and not enough on basic research on the family of diseases called “breast cancer”.
I have an appointment to get mine done next month. Ugh, I dread it every time. I’ve had both male and female technicians. The best one was the one who kept a heating pad on the plate. That was nice, but they still hurt like hell.
I think I may cancel the appointment.
I just saw a memory from 2011 yesterday where I was asking the very same question.
“Coming back from my mammogram today I wondered if guys have a similar exam for their testicles. I doubted it. Then I pondered if they did an SBE* monthly. I didn’t count rearranging as an exam since they do that through their clothes. No conclusions drawn other than very few testicles would have been smashed before they came up with a better way of detecting cancer.”
I had a scare in 2014 which necessitated getting every 6 months a mammogram for 2 years. In the end I was told I just had very fibrous breasts which my Ob/Gyn had told me back in 1992.
*Self Breast Exam
This is one thing that really gets my goat. Mammograms do not prevent anything. If you’re lucky, they DETECT cancer early enough that treatment is simple and no big deal. AFAIK there is no definitive, sure-fire way to prevent any cancer (or most of Life’s Events) anyway. Good genes are a start.
Somehow the message from all the Think Pinkers is “Get mammograms and you won’t get cancer!” Not true.
It’s none of my business, but don’t. Go get it and then come here and bitch and moan to your heart’s content. It’s the kind of thing that you won’t regret doing but you might very well regret NOT going. <ThelmaLou steps down from soapbox.>
I looked that up when I started this thread. Testicular cancer is diagnosed with sonograms. Like I said, if cancer of the balls required putting them in a vise, some guy would have invented a better method yesterday.
I know Thelma, but at my age, I’m not sure I care anymore. Something’s gonna get me sooner or later.
How old are you? I’ll be 73 this year.
I do understand though.
I will be 65 in August.
EEK! That’s very young in my book.
Well, if it helps, I feel older.
But I look fabulous!
I had a guy do a sonogram of my breast, and that kinda freaked me out. I really wouldn’t want a guy manhandling my boobs to get them positioned right for the photo.
The first mammograms I had back in the early 1970s weren’t painful at all, and I couldn’t understand why women said theirs were painful. The procedure was completely different.
I lay on my back on a table, and the camera lens that was positioned to x-ray my breast had a balloon attached to the end of it (a pretty sturdy balloon). The balloon pressed against the breast to flatten it somewhat (gravity was already doing that to a certain extent), and the picture snapped through the balloon. Easy-peasy.
I guess this method either didn’t get good enough pictures or it took too long to process the patients or it wasn’t painful enough-- anyway, when the place switched to the smash & flatten type I finally understood why other women complained about them.
Does anyone else remember this early type of mammogram? I couldn’t find anything on google.