Patterns of breast parenchyma vary widely. Although research into breast density as a separate risk factor (other than obscuring masses) has been done, I'm unaware of studies that quantify risk based on parenchymal patterns. Breast tissue that leads to a false positive reading is likely to be different from breast tissue that generates a true negative screen. Perhaps false positive mammograms are a marker for developing a late-stage malignancy.
I had a false positive a couple years ago that led to a biopsy and money out of my pocket. When I went for my annual, supposedly free, mammogram last year, I received a bill afterwards from my insurance. I questioned it and was told that my doctor had classified the mammo as diagnostic instead of annual screening which triggered the bill. I called my doctor and complained. They told me that since I had a positive mammo and a biopsy, every subsequent mammo would be considered diagnostic. It took quite a few calls and insistence on my part but it was finally changed and coded as a free annual screening.
We need single payer health insurance that covers everyone to stop this craziness.
We need single payer health insurance that covers everyone to stop this craziness.
10
Ellen D. I did skip a year after seeing a 'Times' article about cutting back on the number of screenings. I wasn't ever concerned about getting cancer and didn't know anything about it. I had Stage III breast cancer without even realizing there was a 5cm tumor. After treatment and surgery and five years in remission there were metastases, that have been pushed back with targeted therapies which don't work more than a couple of years.
Would earlier detection have saved my life? So far I've never felt sick but I sure would like to have more time!
Would earlier detection have saved my life? So far I've never felt sick but I sure would like to have more time!
3
why the microscope image?
1
This article, from the New York Times, I have found invaluable. '
This is what it says, in part, "One of the largest and most meticulous studies of mammography ever done, involving 90,000 women and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.
It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation."
"...Many cancers, researchers now recognize, grow slowly, or not at all, and do not require treatment. Some cancers even shrink or disappear on their own. But once cancer is detected, it is impossible to know if it is dangerous, so doctors treat them all."
Just something to think about, talk about with your doctor.
https://www.nytimes.com/2014/02/12/health/study-adds-new-doubts-about-va...
This is what it says, in part, "One of the largest and most meticulous studies of mammography ever done, involving 90,000 women and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.
It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation."
"...Many cancers, researchers now recognize, grow slowly, or not at all, and do not require treatment. Some cancers even shrink or disappear on their own. But once cancer is detected, it is impossible to know if it is dangerous, so doctors treat them all."
Just something to think about, talk about with your doctor.
https://www.nytimes.com/2014/02/12/health/study-adds-new-doubts-about-va...
6
My mother was diagnosed with breast cancer at age 42, and because of that I was told to have a yearly mammogram starting at age 35. I complied, but I am extremely healthy at age 59 and after the Times article noted above, I decided to stop the yearly exams. Especially after one time when (I was 50) they thought they found a tiny tumor or beginning of one. I was sent to a different waiting room, where truly brave women in their 60's and 70's looked at me kindly and told me their stories. A very honest technician brought me back to a screen, where she said, " I don't think this is breast cancer, it's a crystallization from an irritation." I looked and said, " Yes, that's the exact spot where my underwire bra incessantly pokes me all day long." Yay. False positive averted. I am not going back. But I love that honest technician.
1
Insurance companies will often only pay for one mammogram a year. A follow-up after a false positive comes out of women's pocket. After one or two false positives, it becomes too expensive to do this every six months or every year. Been there, done that.
7
You have to take time away from work to come in for a second screening. As someone who has had several false positives and a negative biopsy, it's very emotionally stressful and time-consuming. We need to make this process much easier.
8
I'd like to see a similar article about women who have false positives on tests that indicate the possibility of ovarian cancer and who are subjected to abdominal surgery that requires weeks of recovery--not to mention multiple examinations ahead of the surgery and worries about the loss of protective hormones because of the removal of ovaries. I know that you have a maximum of two false positives for ovarian cancer, but just the idea of being "screened" for something when I have no symptoms has led me to avoid medical checkups.
6
Yet another reason not to start mammography early, when the risk of false positives is highest. You don't want to be completely burnt-out on the procedure before you reach the age when it stands the best chance of helping you!
6
One issue with false positives is that the resolution -- the process of discovering they're false -- requires follow-up that insurance may not pay for and that may be very costly ($2000-$4000). If you can't afford that, why bother?
9
Visiting the doctor for anything takes hours and costs money. If you get a false positive, delaying the next visit makes rational sense - why rush into an experience likely to waste more time and money?
5
Worse than a false positive is a false negative. Been there. I'm Stage 4 now. Women with dense breasts need to know that mammograms aren't our buddies. Mine escaped ultrasound detection too. Those who feel a lump in their breasts not detected by imaging should persist until they get a tissue biopsy.
Sure wish I had.
Sure wish I had.
5
"Early detection results in improved survival" of breast cancer is incredibly misleading. Early detection of BC normally means finding DCIS (ductal carcinoma in situ), which is usually not relevant to health or longevity. Most middle-aged and old women probably have DCIS. But it would never grow or metastasize, and is a normal result of aging.
So all of this early detection of DCIS means that healthy women are turned into BC patients unnecessarily. And since they are not sick to begin with they survive really well.
Because we have been so indoctrinated about the virtues of screening, few people in the US believe that there is anything wrong with the current regime. But Switzerland is in the process of dismantling all of their BC screening infrastructure because scientific evidence does not support its continuance.
So all of this early detection of DCIS means that healthy women are turned into BC patients unnecessarily. And since they are not sick to begin with they survive really well.
Because we have been so indoctrinated about the virtues of screening, few people in the US believe that there is anything wrong with the current regime. But Switzerland is in the process of dismantling all of their BC screening infrastructure because scientific evidence does not support its continuance.
13
"Over four years of follow-up, women who had a false positive were significantly more likely to be given diagnoses of late-stage malignancy. The longer the delay in returning to screening, the greater the risk, though the absolute risk remained small."
Doesn't this mean that it wasn't a false positive?
Doesn't this mean that it wasn't a false positive?
5
Bottom line here unless you have proof that this test or for that matter any test by doctors has clear strong evidence that it will help, don't take them.
It only makes billionaire health execs more rich and allays the fears of hypos, who will nevertheless demand another test and in the end the taxpayer foots the bill...
It only makes billionaire health execs more rich and allays the fears of hypos, who will nevertheless demand another test and in the end the taxpayer foots the bill...
6
False positives also lead to further, expensive, testing. A biopsy is not an insignificant event. MRIs are more accurate, or find more, but are also very costly. Part of the reason why women delay follow up mammograms is financial.
8
On March 22,2016, I went for a mammogram.
"I have nothing but good news for you!" said my radiologist. On May 24, I found a lump. I waited a day, telling myself my mammogram had been normal, but then decided to embrace what I thought was my hypochondria and get myself checked out again. I'm glad I found out I had cancer THEN and not LATER: an aggressive, but thank goodness SMALL tumor was found, and apparently my radiologist got mixed up the first time around. I have a new radiologist. MORAL: be proactive about your health!
http://www.thecriticalmom.blogspot.com
"I have nothing but good news for you!" said my radiologist. On May 24, I found a lump. I waited a day, telling myself my mammogram had been normal, but then decided to embrace what I thought was my hypochondria and get myself checked out again. I'm glad I found out I had cancer THEN and not LATER: an aggressive, but thank goodness SMALL tumor was found, and apparently my radiologist got mixed up the first time around. I have a new radiologist. MORAL: be proactive about your health!
http://www.thecriticalmom.blogspot.com
6
The reason I didn't go back was money.
The annual mammogram was free. But if you are called back - even for something ask or as minor as mine - you have to pay up.
The following year I went to a different facility and had my annual done for free. Same for the next 6 times.
Nothing showed up again.
The annual mammogram was free. But if you are called back - even for something ask or as minor as mine - you have to pay up.
The following year I went to a different facility and had my annual done for free. Same for the next 6 times.
Nothing showed up again.
13
Trauma? Oh c'mon. Weirdly, I got a false positive today. I went in and got it checked again. It was not traumatic. It caused some anxiety, then a thrill of relief. I value mammograms even more now because of the thoughts I had before I knew it was a false positive. Those thoughts being a bummer...
5
I'm sure you didn't mean for your comment to come across so flippantly. You imply that your false positive was resolved in one day, or at least in a straightforward way. However, there are many limitations to the various technologies leading to inconclusive results. And, for some of us, after a positive screening mammogram, that means a second (diagnostic) mammogram, followed by an ultrasound, followed by a biopsy. Then, when a few doctors are so suspicious that the negative biopsy results could be wrong, it's followed up with another ultrasound, then another mammogram. When this stretches over weeks, yes, it is traumatic. I'm told that the need for multiple tests to definitively rule out is not rare. Surely, not comparable to an actual diagnosis, but no walk in the park either. I was like the women in the article- I could not muster up the will to go back in the recommended f/u time (6 months), but I did go back a few months later.
8
In the absence of more precise diagnostic tools mammogram is still the only tool available for early detection despite its shortcomings. Especially in the case of aggressive type tumors benefits outweighs the risk.
2
@Anne - Mammography is not "the only tool available." Ultrasound works too. Ultrasound picks up some masses that mammography misses, and vice versa.
5
Ultrasound works on dense breasts and is often used in conjunction with a mammogram. MRI is often used for those with dense tissue AND a family history. As someone with dense tissue and cystic breasts, I just wish every visit wasn't so drama-filled.
1
Interesting article. Can I suggest a column on what type of mammogram is appropriate for someone prone to false positives? 3D? Ultrasound? The advice is confusing and insurance coverage is inconsistent.
13
Enough with the "trauma" or "anxiety" about false positives on mammograms (and the common followup biopsies of things that turn out to be harmless.
It's not just about women's emotions. It's about wasted time, energy, and medical resources; it's about possibly putting one's life and one's family's life on hold for weeks at a time; and about exposure to up to dozens of x-rays and undergoing invasive procedures.
Funny how articles about the ups and downs of prostate cancer screening don't refer to men with false positives as having experienced "trauma."
It's not just about women's emotions. It's about wasted time, energy, and medical resources; it's about possibly putting one's life and one's family's life on hold for weeks at a time; and about exposure to up to dozens of x-rays and undergoing invasive procedures.
Funny how articles about the ups and downs of prostate cancer screening don't refer to men with false positives as having experienced "trauma."
46
Over the 25 years that I have been getting mammograms I've had many false positives for one reason or another. The anxiety is almost disabling for me now when I go for a mammogram. Yet I continue to go yearly although I have often told myself I would take a year off. I never have. Am I just being compliant, doing as my doctor tells me to? I like to think that continuing to go yearly is good for my health. So far it seems to have been. Hopefully the anxiety is worth it.
3
Please keep going for mammograms. I skipped for 3 years & paid for it. There was also confusion at this time when recommendations came out that mammos were not necessary every yr & "the powers that be" wanted to save money. Found a large tumor (5cm), had chemo, surgery, & radiation because this type of breast cancer is very aggressive- HER2. If I had gone earlier I could have caught the tumor in a much smaller state. A long year of painful treatments & an additional yr and a half of recovery (gaining strength) But, I am here!!!! ( in remission) :) [When younger, I went for retesting after false-positive.] It is a gamble when you avoid it!
Never Miss Your Routine Mammogram, even after false positives.
My wife did miss one year and a HER2 positive cancer was found, growing quickly, a year later when she had her next mammogram. She's fine now, but if a very aggressive treatment program could have been made less so by earlier detection it would have saved her a great deal of pain and distress.
My wife did miss one year and a HER2 positive cancer was found, growing quickly, a year later when she had her next mammogram. She's fine now, but if a very aggressive treatment program could have been made less so by earlier detection it would have saved her a great deal of pain and distress.
7