Articles > Balanced Living > Our Breasts - to scan or not to scan

"The statistic that is most commonly quoted is that by detecting breast cancer early..., mammography reduces the mortality rate from breast cancer by 20 to 30 percent. So fixed has this statistic become ... that by repetition alone it has now attained the status of unimpeachable fact.

However, advocates of screening rarely ever talk in terms of absolute risk. Instead, they prefer to express the benefits of screening in terms of relative risk, a statistical concept that, because it is expressed as a percentage, makes the benefits of screening appear much more dramatic."

Cancer Screening is an important issue that directly effects half of the human race - I wanted to be sure that when I made my decision to be screened or not, that I had as many facts and figures available as possible - and not simply have the media hype and hysteria as a basis for living! So I did some research and made my decision. What I intend to do in this article is to to explain my decision, and my reasoning.

I have chosen to share this process, because I think that far too few of us actually take responsibility for making health decisions in our lives, and because the medical establishment seldom has the time (or the inclination) to inform us fully on all sides of every issue necessary to making informed decisions.

I do not mean to imply that my decision is right for all women. However, I hope that this brief explanation of how and why I have made my decision, and the way I approached it, will inspire and enable other women to make their own decision about screening, and to feel happy and confident that their decision is right for them.

I was prompted to look carefully into breast screening when I recently received a summons to present myself for an appointment. In Scotland, it has been decreed that all women over the age of 50 should have a mammogram, and that they should have one every three years until the age of 70. They may request ongoing scans thereafter. Along with the letter telling me the details of my appointment, a descriptive booklet was enclosed. I was very pleased to see that the booklet was devised with some care and several important points are mentioned:-

• That the screening offered uses x-rays, and thus we will be exposed to radiation during the process

• Some women find mammograms uncomfortable or even painful

• Around half of the cancers discovered are small enough to be removed... which means that the whole breast does not have to be removed

Unfortunately, they also make several claims that sound more like media hype than accurate reflections of fact. They do not lie about anything, but they do leave out some relevant information.

My Decision

I have decided NOT to have a mammogram at this time. There are several reasons that I have come to this decision, and I will try to explain them as simply and briefly as possible.

ISSUE 1 When should you first start having screening?

This issue arose when I read about the American program of expecting all women to be screened from the age of 40. In regards to this I found a very illuminating quote:-

Cornelia J. Baines, MD, of the University of Toronto, deputy director of the prestigious Canadian National Breast Screening Study, has written several papers that are critical of screening mammography. She writes: "An unacknowledged harm [of screening mammography, ed.] is that for up to 11 years after the initiation of breast cancer screening in women aged 40-49 years, screened women face a higher death rate from breast cancer than unscreened control women, although that is contrary to what one would expect" (Baines 2003).

Now this got me to thinking... our delightful medical bureaucracies have a very difficult challenge when categorising women. They appear to use the age of 50 as the age when most women have reached menopause. In other words at 50 most women are expected to have ceased menstruating. This also implies that their breast tissue has become less dense, and thus easier to scan accurately.

Well now, I am certainly in peri-menopause, that delightful period when our hormones are causing hot flushes, headaches and emotional extremes. However, I have not stopped bleeding, and my breasts are still firm and dense. So, I believe that to have my beasts scanned before I reach menopause is very likely to do me a great deal more harm than good.

So, I will not even consider having my breasts scanned until after I reach menopause.

ISSUE 2 How safe is is to have regular scans? Or, put another way, what is the safe level of radiation?

The simple fact is that there is NO SAFE LEVEL of radiation. That said, we are all exposed to minute amounts of radiation every day. Natural sources of radiation include sunlight, and granite. And of course, there are varying amounts of radiation from all sorts of man made sources.

We cannot avoid being exposed to some radiation, but I choose to be exposed to radiation just as little as possible. In other words I will avoid radiation involved in breast screening unless I believe that I will truly benefit from the screening.

However, there is little to commend breast screening to me. For a start there are a vast number of scary statistics out there. And most of the statistics that I have been able to find regarding the UK are those that have been translated for or by the media. So, by definition they are startling, dramatic, and misleading. The same is true for the American media of course, but at least Dr. Moss provides us with articles to put things in perspective.

Dr. Moss explains that the type of statistic most often quoted in the US is that screening reduces your chance of dying from breast cancer by 30 percent. However this is the relative risk rather than the absolute risk, and it is used ONLY because sounds more persuasive.

The absolute risk that this describes is that:- For 50 year olds, 10 years of regular mammography might at best be expected to reduce the absolute risk of dying from 6 in 1,000 to around 4 in 1,000.

I have no doubt that the dramatic British statistics follow the same pattern. Having had many years experience in PR and in the media, I am loath to trust their spin.

The way I read it is that regular mammograms appears to reduce the risk of death for a small percentage of women... but they have no idea whether there are other valid indicators. Personally, I feel that regular doses of unnecessary radiation will in the long run cancel out any potential good.

ISSUE 3 How relevant is the fact that members of your family have had breast cancer?

Another great fear for many women is that they are much more likely to get breast cancer if their mother, aunt, or grandmother had it. However, the genetic link appears to be VERY RARE. In my case, all three of the mentioned female relatives had breast cancer, but each of those cases was very different.

My beloved aunt died young and no doubt the cancer was not handled very well back in the early 70s. My grandmother had breast cancer, but she was in her early 80s when she had her breast removed, and within a couple of years the cancer had spread throughout her body - which appears to be a typical example of a slow growing tumour being removed only to encourage a rash of growth of hundreds of seedling tumours throughout the system. My mom had a small tumour removed at the age of 68 and happily, she is well and able at 82.

My take on the issue of cancer is that is is far more likely to be due to environmental and social influences than anything else. One reason that I believe this is the extreme rise of cancers since the pharmaceutical companies began to flourish (for instance crop spraying, vast quantities of food additives, and manufactured/unnatural drugs are largely a phenomenon of the 20th century. So is cancer. Another thing that supports this belief is that there has been a huge amount of success in so called fringe medicine - where a cancer sufferer makes dramatic life changes and the cancer disappears, or at least does not grow.

I think we would be wise to accept that our toxic environments, and crazy living styles impact on our health big time. I know this to be true for every other illness and condition - why on earth would cancer be different.

I do NOT want to find a cancer early, I want to prevent the cancer from forming in my body.

The great GOOD NEWS that the drug companies and most medical practitioners DON'T want to tell you, is that you CAN TAKE PREVENTATIVE ACTION!

What I am doing to protect myself, and hopefully prevent cancer:-

Healthy eating - Over the last twelve years, we have slowly improved our diet.

• All the fruit we eat and the uncooked vegetables are organic, so that we are not taking in huge amounts of chemicals that our bodies cannot eliminate.

• We DO read the labels on all foods

• Have reduced sugar - and replaced it with honey and brown sugar which have some food value.

• Avoid all those very scary low fat fast foods that appear to contain more chemicals than foodstuffs.

• Eat loads more fish.

• If we eat meat we make sure it is organic or locally raised, and not shot through and through with steroids, antibiotics and other chemicals.

• Drink less alcohol, and then stick with organic wine where possible

Healthy living - Improving the way I live so that I can grow old, and still be fit and active. I:-

• Have a job that I love and that I am pretty much in control of

• Give myself time off - daily I take an hour out for myself, weekly I have at least one full day off, and we have several short holidays a year (for me long holidays are stressful)

• Have wonderful friends and know that they are there even when I am not in touch

• Make time for socialising

• Make time for romance

• Spent time outdoors in the country, and in my garden

• Do yoga and chi kung regularly

• Love life

Handling stress - Stress is essential to life, it gives up impetus, excitement and stimulation, but we have to learn how to handle it:-

• Laugh.

• Laugh at yourself, at laugh and everything that tickles your funny bone.

• Learn to shut up that dreadful little voice inside your head that is always wondering what if...

• Breathe. That is right, breathe, deeply, slowly, regularly. Take five minutes several times a day to breathe deeply - especially outside in the fresh air (many buildings are filled with toxic fumes from everything from cleaning products to office supplies)

• Make time to have fun

• Take time to unwind every evening

Test my own breasts

No doubt all women have been shown loads of times how to check their own breasts for lumps and bumps. (If you want to be reminded, no doubt your local nurse will be very happy to remind you).

I know that I have not always done a monthly check, but I intend to from now on. (Another possibility is to have a significant other do the test - after all they should know exactly how your breasts feel! Besides, this makes it much more like fun and much less like a clinical fearful experience!)

Massage my own breasts

Another great idea I stumbled upon is the idea of massaging my own breasts - this seems to me ever so much nicer and less clinical that the examination thing. Massaging your breasts regularly will not just tell you if and when there is any change in the breast tissue or texture, it will open you to all sorts of positive personal changes.

For a start breast massage is comfortable and comforting - so in doing it we are nurturing and caring for ourselves. Breast massage will also effect how we feel about ourselves as women and as individuals - try it and see!

Keep an open mind

Although I am very happy and clear on my decision, I totally accept that new treatments and scans are likely to be developed. I do not reject the idea of scanning for all time, but it is not for me, for now. I will keep myself up to date with the latest findings and read the Moss Reports newsletter every month! Dr. Moss has a wonderful web site http://www.cancerdecisions.com/ and I highly recommend his regular newsletters