I had my one and only mammogram sometime in my 30s, after my husband noticed “different textures” in one of my breasts. Even the technician told me it was going to be difficult to capture good images, and maybe to see anything in them, because my breasts are fairly full. By the time it was finished, I didn’t care whether they could see anything, I didn’t want to go through that again.
It turned out those lumps that so ruined the mood for us, and for more than a week, were due to “fibrocystic changes.” I learned to live with them as a constant reminder of how I didn’t want to track every one down. They’re not always in the same place. They were most likely to appear and become tender to add to the joys of PMS, or if I overdid caffeine, or for any other reason retained water. I know how to recognize them, know my breasts pretty well by touch, if not the regulation self-exam routine, and don’t let it freak me out.
I don’t have a lot of other big risk factors: The only breast disease in my family history is one cyst that my Mother had surgically removed before I had breasts. I nursed two babies for six months or more each. I did live with a smoker for most of my first 21 years, and I did take oral contraceptives. But I’m sick and tired of telling all that to every doctor I’ve gotten near for 20 years. I may be even more tired of explaining it to well-meaning friends and relatives who’ve made other choices. My best friend, a Type A (and AA cup; we’ve discussed which makes for a more painful mammogram, but at least they can see something in hers) married to a pathologist, frets with the overall statistics for me. But “one in eight” is over all risk levels, over all of a woman’s lifetime. My nephew’s wife lost her mother to breast cancer, so I don’t even want to open the question with her. But it’s just never been my issue … or my choice for myself.
That’s the real crux of the new recommendations. They give us new professional analysis of the statistics. They put nuance in the weighing of risks and processing of information. They equip each of us, in consultation with our doctors, to make better decisions for ourselves. No one is having anything taken away from her that gives her reassurance against what she fears most. But for those of us who are most afraid of the test – because it hurts, because it’s one more exposure to x-rays, because it’s far from a perfect screening method, because it potentially forces us to choose invasive treatment for mistakenly identified nonproblems – we are freed to make our own choices for our bodies. I for one am fine with some greater risk that one of those lumps could get away from me. I’m willing to trade some very low level of constant dread for the annual dread of the glass plates.
