Can we talk about breast cancer overdiagnosis?

I'm not there (40) yet, but almost. I'm not looking forward to that mammogram at all. I feel that way about hysterectomies though.

I would suggest comparing 5 year survival rates in the US versus other countries before getting to worked up about over diagnosis. Early detection and treatment is why we have the highest survival rate for breast cancer in the world. But no one is forcing you to start having mammograms or having annual mammograms.

I agree - mine reads it immediately and if an ultrasound is required does it immediately.  Now that may not be standard. I have dense breasts so always require an ultrasound, and a family history of breast cancer before 50.  

I am firmly in the camp of early detection saves lives. I would much rather have my mammograms and them find something and have it biopsied and it be benign, than not get them and not know about troublesome spots. Unfortunately, you cannot tell with ultrasound and mammograms alone if a lump is nothing, or if it is malignant. Perhaps someday science will get us to that point. Wouldn't that be amazing! . But, for now, we cut. And I'm ok with that. But I know not everyone is.

I agree with you. I've read recent studies that show that going to the doctor for regular check ups, etc, actually has a negative impact on one's health.

My mom was diagnosed with non-Hodgkin's Lymphoma almost 14 years ago. At the time of diagnosis, it was indolent (slow-growing) and it did not respond to treatment until it transformed into an aggressive cancer. She likely had that cancer for many, many years before diagnosis. She was in remission for many years, and now has tumours again, and has for several years. But it is indolent again. So she, and all of us, are living with cancer. It's stressful. Even if it's not an every day stress, the knowledge that cancer IS there and growing slowly is something that is hard to live with every day.

So, in some ways, I totally think early detection is NOT always a good thing.

I do see what you are saying and I'm sorry you're going through this. Hopefully it will turn out to be nothing and then you won't have to make any decisions at all.

From the other perspective, in the last three years my dh has ended up with early screening for two conditions which if he waited until they are both recommended at age 50, he wouldn't have been around for those screenings. In both cases, there was no family history of either type of cancer so we weren't expecting that news. I'm grateful that we have a health care system where we can be proactive if we choose to go that route.

If you don't want to know, you have the choice not to follow up, just as you have the choice not to choose any treatment.

I prefer to know exactly what's going on so I can make the most informed decision possible. I had, like you, my first mammo last year--cysts, called back, had US, had biopsy. All was fine, just as I expected it to be. I did wait until 42 to have that first mammogram because there is no history of breast/female reproductive cancer in my family. I would gladly have waited until 50 but my new family doctor insisted. I could always have refused, though.

The US's 5-year survival rate for breast cancer for women over 65 is fantastic, possibly attributable to better screening under Medicare.  If you are comparing survival rates for those under 65, the U.S. is somewhere in the middle of the pack.

I don't get to say this very often, but: Yubon, I completely agree with you.*

*Except for the part about not being treated if you're diagnosed. You have a young child. You'd be a fool to refuse treatment that may save your life. Do you really want the ex and his GF raising your kid?

We absolutely over diagnose and over treat breast cancer. If statistics say we have better survival rates than other first-world countries, that's probably from diagnosing younger and younger woman with precancerous conditions that we then treat, but were unlikely to ever progress to a killer cancer if left alone in the first place.

I looked at that thread a couple of days ago asking people to identify causes of death in numerical order. Every response I looked at placed breast cancer way, way too high on the list. More women die of lung cancer than breast cancer. Far, far more women die of heart disease than breast cancer.

About the over use of chemotherapy: it's kind of a crapshoot. Many women will survive breast cancer on their own without chemo. Some will die anyway, even after chemotherapy. There's maybe 10-15% of breast cancer patients whose lives will actually be saved by chemotherapy.

I think I fall into that 10% category. My cancer was very aggressive and it was treated aggressively. But I've been cancer-free for 17 years, so it was worth it. But we really don't know which women will be saved by it, so ... yay! chemo for everyone!

My cancer couldn't be seen on a mammogram, even after it had been positively diagnosed. The younger you are, the less likely a tumor will show up via mammogram alone. And the older you get, the more likely a cancer will be diagnosed via mammogram, but it's also more likely to be a slow-growing, non-threatening cancer that doesn't truly require treatment. But we keep diagnosing them and treating them nonetheless.

That's why I think over-reliance on mammograms and the accompanying hysteria we see here and elsewhere that 40-something women congregate is a waste of time, money, and most of all emotions.

And as always on these breast cancer threads, I recommend you get familiar with Breast Cancer Action. It will give you a lot more straight talk about breast cancer, its causes and treatments, the breast cancer industry and the politics of it all, than a dozen Susan G. Komens will.

I'm sorry you're facing this. But I think your anger is misdirected. If you don't want to seek medical attention, don't. But don't call it a scam when so many of us have friends and family with us because of those life-saving efforts.

I also have dense breasts and started having mammograms in my mid-30s. As a result I have had more than my fair share of biopsies. That I could have refused, but it would have been foolish to do so.

Cancer is the second leading cause of death in women in the US. Breast cancer is the second leading form of cancer deaths in the US.

I had an early diagnosis, a small tumor, positive lymph nodes and no family history on my mother's side. I choose a lumpectomy, chemotherapy, and radiation. It all sucked. I had severe burns, missed months of work, became depressed, and struggled through treatment. I'm only 9 months out from the end of my treatment and I'll never be back to "normal." Cancer changes you. I am glad I had the choice of treatment and as much as I hated it I'm grateful I had the choice of aggressive chemotherapy that other countries don't offer because of the expense.

You can make your own informed decisions about how to follow up or if you even want to follow up.

I know someone who was diagnosed over 6 years ago with cancer in both breasts. She has chosen no treatment. She has mammograms every 6 months to see if the cancer has spread and is fine with not being treated...not a choice I would make at 55 but it's her life.

I'm curious about your term "over diagnosis." You either have cancer or you don't, no?