Missy Diggs

Here’s a copy of an email I just sent to my lovely and wonderful support group, in response to recent news reports about some government panel’s new mammographic screening recommendations.

Y’all have probably been hearing the news about the government panel that just issued new recommendations for mammographic screening, and what they said was: Don’t worry about getting mammograms every year when you turn 40. Just wait til you’re 50. Some people have also gotten the idea that it’s not worth it to do self-exams, either.

I’ve been reading a lot of reactions and debate about this recommendation from all the folks in my various cancer communities, and here’s what they (and I) think:

These guidelines are based on some kind of huge “public health” financial model and do not actually apply to individual people. For most individuals, the most prudent thing to do is go ahead and get mammograms starting at 40. Or before that if you notice anything or feel worried. And definitely continue to do self-exams.

Here are some facts to take into account:
Most cancers and recurrences are found by patients, not by doctors or through screenings. (so do self-exams!)
Most women who die of breast cancer were not receiving annual mammograms. (so get mammograms!)
Most women who develop breast cancer have no family history of the disease. (you may be at risk even if you don’t know it!)
Men can get breast cancer too. (so if you think something’s going on, get it checked out!)

It doesn’t have to be a lump to be cancer. Monitor any change in the color, shape, texture, appearance of breast tissue. IBC, for example, often starts out looking like a rash or a bug bite. If you notice any change that lasts for more than two weeks, see a doctor and ask them to rule out cancer.

Here are some statements that doctors sometimes make but that do not count as ruling out cancer:
“If it hurts, it’s not cancer.” (sometimes cancer hurts. Why wouldn’t it?)
“If it responds, even slightly, to antibiotics, it’s not cancer.” (Trust me, this is not necessarily true. If it does not respond completely to antibiotics, it may be something other than an infection. Get a mammogram. If that doesn’t show anything, get a biopsy. Find out what it is.)
“If you had cancer, it would show up on the mammogram.” (not necessarily: IBC and some other types of breast cancer can be difficult or impossible to detect on a mammogram. If you have a clear mammogram and nothing else is going on, congratulations! If you are still concerned about changes you have noticed in your breast, keep going. A clear mammogram is good, but if you still have questions, get them answered.)
“You’re too young to get breast cancer.” (The youngest breast cancer patient is not even 12 years old yet. If she’s not too young, you’re not too young.)

I don’t usually send out bossy emails like this but the recent news is so concerning to me because even the people making the recommendations admit that lives will be lost. Mammograms are not fun, and it can be a huge relief to hear that the experts say you don’t have to start getting them yet. But I encourage you to do more research before you decide to wait til you’re 50 to start being screened. Find out what your doctor thinks. I don’t want any of you to have to go through what I’ve gone through. I was 37 when I was diagnosed, and I am the first person in my family to get cancer. I love you, so please take care of yourselves.