I fully expect to die of breast cancer before I'm very old.

It's not a wholly rational fear, I grant you. I'm thin enough, I exercise, I eat low on the food chain, I'm not taking any kind of estrogen, and (heavy sigh) my once formidable cocktail consumption has been dialed back to a couple of glasses of wine a week. Yes, there is a family history. But I've shelled out the money for the genetic testing, and the results came back negative. Besides, given my stress level and control-freak, Type-A nature, I'm likely to drop dead of a heart attack years before my mammaries malfunction.

Still, there's something about the idea of one's breasts--body parts tiresomely fetishized from the moment they spring forth--turning lethal that makes some women crazy. Count me among them.

It doesn't help that I have some of the screwiest breasts this side of the Mississippi. Oh, they look perfectly normal, and, when it came time to nurse my children, they worked just fine. But, clinically speaking, the tissue is a disaster, so dense and knotty it renders mammograms largely useless and self examines an impossibility. Pretty much every doctor who checks me out gets this awed look on her face, and radiation technicians, despite my advance warnings, are always like: Dang, those are some dense breasts! I never know whether to say "Thanks!" or slap their faces.

A little over a year ago, my ob finally sent me to a breast surgeon, who wound up recommending I get screened every six months--alternating between a mammogram-sonogram combo and the more involved MRI. Better safe than sorry, right?

Not necessarily. After chewing it over for a few months, I decided to object. Even setting aside the radiation (it's minimal these days) and the creepy chemicals they pump into you before stuffing you inside the coffin, er, MRI tube, it's the grinding anxiety leading up to the tests that really gets me. Factor in the conflicting data about the value this level of screening provides in reducing the odds I'll be eaten alive by my own breasts, and I reached the conclusion that, barring scary new developments, I prefer not do this dance twice a year for the rest of my life--which is the discussion I must have with my breast surgeon at next week's appointment.   

As you might imagine, this week's uproar over the federal advisory panel's less-aggressive breast-cancer screening recommendations has been of more than passing interest to me. I had read the reports, weighed the risks, and made my choice long before the controversy hit the front pages. (This debate is, in fact, decades old.) Now, watching as charges are hurled over whether the feuding factions have been financially or politically influenced, I'm both sad and annoyed. These decisions are hard enough for women to make without tossing politics into the mix. And yet, who can blame people for being paranoid in light of how casually science has been manipulated for political purposes in recent years.

One bright spot: Hopefully the controversy will prompt more talk between doctors and patients. Obviously, not all breasts are created equal (to the great delight of plastic surgeons and teenage boys everywhere), and when it comes to screening, the picture has never been as clear as most people assume. 


Related Link:

Will the Government Really Start “Rationing” Mammograms?, by Suzy Khimm