"Mad" About Mammograms

Read about how a young wife and mother learned of a breast cancer diagnosis at the age of 41.

"Mad" in both senses of the word—crazy happy for mammograms because ten weeks after mine in January 2009, a stage 1 tumor was taken out of my body; and my life began anew as a "survivor." 

And angry mad about mammograms because ironically, on the first anniversary of my mammogram, in November 2009, there was big news—a recommendation to change the mammogram guidelines. The study reported that women under 50 benefit from them, but their limitations (overdiagnosis and unnecessary biopsies) outweigh those benefits for those not at high risk. 

I was in a tizzy, along with many other under-50 survivors, and joined those who started a petition on breastcancer.org. I had not yet been vocal about my experience, but that day I felt compelled to hang out the banner I posted on Facebook.

A mammogram had saved me from chemo, and had possibly saved my life. There is absolutely no question that mammograms save many lives.

Back to November 2008, sitting in the hallway of the breast imaging facility, next to an elderly woman, we were both still wearing our gowns. Funny how certain memories remain ingrained. Another irony—the radiologist came out and told her she could get dressed and leave while he took me to another room.  

Calcifications are calcium deposits that show up as white spots on a mammogram.  The way they were grouped caused the radiologist to label them as "suspicious".  But he said three out of four times they were harmless. 

I was given a piece of paper with breast surgeons names on it. I didn't recognize any of them, there had been no reason to go to one before. I hadn't been considered high risk. My family history wasn't heavy with breast cancer—I later learned that only a small percentage (10-15%) of breast cancers are hereditary. I had my first child at 27 and had nursed three children for four years (this lowers your risk). The thing is you don't always know you're high risk until you get the first biopsy results.    

Helene is a 44-year-old breast cancer survivor, mother of three, and resident of White Plains.  She works as a freelance editor of legal study guides.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

NAO October 12, 2011 at 01:14 AM
Thank you for your courage to speak out and share your story. Congratulations on two years almost three years cancer free. Naomi
Helene Schonbrun October 12, 2011 at 01:37 AM
Thanks so much Naomi.
Bongaloo October 12, 2011 at 01:22 PM
Congratulations of your success. Wish you the best of health. But your story is one example, and not necessarily a conclusion. You say that the mammo saved your life. But, to offer an alternative...there is no proof that had you been diagnosed six months or twelve months later that you wouldn't have lived. 10,000 women under 50 need to be screened to find one cancer. There are hundreds of suspicious "abnormalities" which need follow-up and biopsies. The question is not an easy one to answer. Do you have 10 women undergo biopsies for find one cancer? Probably. But, would you encourage 500 to have a test only to find one cancer? What about 5,000? Had your cancer been found on physical exam (without mammo) six months later than the mammo found it, would your treatment have been changed? Would you have still survived? I hope so, but it's a difficult dilemma. Could 500 people be "saved" the inconveniece, expense, and anxiety by not going for a screening mammogram, if the downside would be a lumpectomy and radiation for you? I am not choosing the answer for you. I am offering an argument. Your story implies everyone should have a mammogram because you benefitted from it. We should hear from the 500 women having biopsies....albeit needlessly, because they didn't have cancer...and ask them if their "price" was worth your "benefit". It's really difficult to look at cancer that way. Seems so cold and calculating. But it's the reality of mass screening.
Helene Schonbrun October 12, 2011 at 04:03 PM
Hi Adam, you're right that this is my personal story, and I am merely an example. There isn't much about breast cancer that is a universal truth -- women find out about their cancer in different ways, make their decisions about treatment based on many personal considerations, and because of the new way of analyzing the biological elements of tumors, treatment is tailored for each individual woman. I had already planned to discuss in my next blog the various methods of screening (all of which I went through) and the pros and cons of each one. I am not one to get too wound up in statistics because I have often found myself on the wrong side of them, but I do know that out of all the screening methods, mammography picks up more tumors early. Also, I never said that the mammogram saved my life -- without the crystal ball there's no way of knowing when the tunor would have been picked up. I said "possibly saved". Although, I am relatively sure that it saved me from chemo which will be better explained by future blogs. (cont'd in next Comment)
Helene Schonbrun October 12, 2011 at 04:04 PM
Also, you make light of what you call the "downside" of a lumpectomy and radiation that you would subject me to in order to save 500 people from the inconvenience of having mammograms and perhaps follow-up biopsies. Lumpectomies and radiation are no mere "downside" to those who have gone through it. And where is your crystal ball -- who is to say that my tumor would not have been picked up only after lymph node invasion and/or chemo was deemed necessary -- even six months later? My purpose in writing this blog was not to imply that there is a "right" or a "wrong" when dealing with breast cancer. It is to encourage women to have a conversation with their doctors to discuss what is best for them and not to be guided solely by my words or your words or a vague understanding of studies. Knowledge is power. Oh, and sorry, I can't help it-- I don't think that you'll find anybody who will disagree -- mammograms are now the most effective tool in the early detection of breast cancer and mammograms do save more lives than ever before. I hope you will continue to read my story in the next few weeks to read about the issues involved and to learn about the decisions I made.
Shirley W. Homes October 12, 2011 at 04:21 PM
Has life become so cheap? Is there a dollar number for saving one life? Is there a ceiling for inconvenience if one life may be saved? Yes, let 1,000,000 women be tested if one can be saved. Have we come to a place in our society where we have forgotten the value of one life? As the mother of a daughter whose "under 50" cancer was ignored by her physician for seven months, until it had advanced to stage three, I would ask that we continue to test our YOUNG women, no matter the cost. Shirley Homes
Bongaloo October 12, 2011 at 04:36 PM
I am only offering a different opinion. I am bringing this up for discussion. I am not picking who is correct. Your statement: "I don't think that you'll find anybody who will disagree -- mammograms are now the most effective tool in the early detection of breast cancer" is partially contradicted by the Task Force who issued a contrary recommendation. These scientists, statisticians, and physicians reviewed hundreds of studies of tens of thousands of women and said that mass screening of women 40-50 has no "proven" benefit. They did not say these women can not get mammos. There is a benefit but not outweighed by the risk. Seat belts save lives, but some people wearing seat belts die. A cholesterol of 200 is higher risk than 160, but we don't treat everyone with a # of 200. We are willing to accept a higher risk rather than the expense and side effects of treatment. If mammos are effective for women over 50, does that mean 40 is good too? Then why not 30? Some women get breast cancer in their 30's but should we screen everybody? Then why not 20? At some point you have to take the risk of not screening? Every time you get in the car, you take a risk you might die in an accident. We can not screen every person for every disease especially when we have imperfect tests.
Shirley W. Homes October 12, 2011 at 10:22 PM
Why do we' have to take the risk of not screening'? What is gained by not finding an early cancer in a young person? What is analogous about riding in a car and breast cancer? One is a choice...a decision, and the other, believe me, is not. Your logic is skewed.
Bongaloo October 12, 2011 at 11:32 PM
I think that saying screen a million people to find one cancer is skewed logic. Every test has consequences. Financial expense, emotions and anxiety about abnormals, and further testing and biopsies. If you think that women over 50 need a mammo fine, but why not 40 or 30 or 20? Should we do mammos of 20 year olds. There is a risk to testing, including radiation exposre, physical discomfort, etc. Every medical decision evaluates the risks and the benefits. You decide if you want to take the risk of driving without a seatbelt. You take the risk of missing a cancer by not doing a mammo. Instead of yearly, why not every six months? It's possible you could have a normal mammo today and develop cancer three months later. Someone has to decide is it over 40 or over 50, is it six months, yearly, or every two years? We can't just say "Shirley's daughter got cancer at 47, so everyone needs a mammo". I am truly sorry your daughter's cancer got diagnosed late. But public policy has to go by studies. The US Task Force looked at the data and made the recommendation to not screen every woman under 40 every year. But people say they don't believe the data and the experts are wrong and we must do it. That's skewed logic. There is a benefit to screening, but there is also a downside. You need to look at outcomes. Helene got diagnosed early. Had she been diagnosed 6 months later, her outcome might have been exactly the same. Did the mammo "save her life" or diagnose a slow growing cancer early?
Shirley W. Homes October 13, 2011 at 12:46 AM
Thank you, Helene, I look forward to the rest of your story.
Leyla Nakisbendi October 13, 2011 at 12:56 AM
Statins need about 65 people to take the drug before the 66 person is helped by it - that is the "number to treat". No one suggests that it is too expensive to treat those 65 people with statins, just to help the 66th person! Every man gets a PSA and no insurance company denies a prescription for Viagra yet there really is no ovarian cancer screening test nor are birth control pills usually covered under a prescription plan!
Leyla Nakisbendi October 13, 2011 at 12:58 AM
I, by the way, also had DCIS, lumpectomy and radiation. I didn't even think twice about doing it. It was found early and was taken out, who knows what would have happened. I was lucky that I had insurance and knew a great breast surgeon who came in on Christmas eve to see me. I didn't have to struggle to find someone.
NAO October 13, 2011 at 03:05 AM
Adam, I have a question. How many people do you know who have had breast cancer (I don't mean acquaintances-I mean friends)? I have 2 really good friends who have had breast cancer-one's life was forever altered because a "top" doctor who was addicted to pain medication and butchered her. It has been almost 6 years and she still recovered emotionally. I think that most women do not enjoy mammographies but we feel that it is a necessary preventative. A family member had an abnormal mammography and biopsy-it turned out to be a calcification. But she was lucky. How many women do not have access to the same medical care that you or I have and how many women die from breast cancer each year? One life lost that was preventable is one life too many (whether it is breast cancer or prostate cancer). Life is precious we need to start valuing it again. Unfortunately, in the US we have become so focused on money that things like health are not paid attention to. That is sad. What we really need to do is come up with a less invasive test that will save lives. We have the technology to make a cellphone act like a computer, but we do not have the technology to create a robust test that will save lives. Thank you. Naomi
Bongaloo October 13, 2011 at 12:49 PM
This is an academic discussion, not a personal one. This has nothing to do with Viagra. Saying men get PSA's so women should get mammos is selfish, not accurate. The same panel recommended men to consider NOT get PSA's as there is no proof it saves lives. A doctor on drugs is horrible, has nothing to do with this discussion, although actually favors against doing mass biopsy. The issue is that mammos haven't been proven to save lives in women under 50. But there is a large group of people who insist they know better.Lobbyists & special interests: hospitals, doctors, and pharmaceuticals -- earn money based on screening, even though there is no proven benefit. The data doesn't support the recommendation. It doesn't say you can't have the test, it says you need to consider the pros & cons. The friend who had a biopsy for benign calcifications did not have her life saved by the test. There are some women whose cancer is detected earlier by mammo than would have been without mammo. The question is: did mammo save their life, preserve their body, or reduce the need for chemo or hospitalization? How do we even know mammos save lives--there are studies to prove this, but so far it's only in women over 50 in a general population group, not in friends of NAO. If 10 mammos could save 1 life, it would be great. If it were 10 million, is it worth it? That's a question. What if patients had to pay $100 for a mammo? $500? Do we insist everyone gets free mammos & give someone else the bill?
Bongaloo October 13, 2011 at 12:51 PM
"What we really need to do is come up with a less invasive test that will save lives. We have the technology to make a cellphone act like a computer, but we do not have the technology to create a robust test that will save lives" -- was a comment posted earlier. That's absolutely correct, we don't have the test yet. Which means we might consider testing less, not more. There is no good test for ovarian cancer so we don't screen for it. We don't have a perfect test for breast cancer so we need to consider how, when, and whom we perform this test. But if we admit it's not perfect we shouldn't demand to do it on people who might not derive a benefit from it.
Alexandra October 14, 2011 at 07:14 PM
There is no doubt that early detection is key when it comes to cancer. I, for one, will welcome my routine mammograms, sonograms, CBCs, pap smears, etc... If there is something there to be found, I pray they find it as early as possible. I would not quibble at a biopsy if I needed one. I'd rather have a biopsy come back negative than have a situation go undetected. Just my opinion, but I can assure you it is shared by the members of my family!! (I am a leukemia survivor and one of my sisters is a breast cancer survivor). Helene -- you are an inspiration to us all.
Shirley W. Homes October 14, 2011 at 07:33 PM
A mammogram is not an invasive procedure....slightly uncomfortable but nowhere near as uncomfortable as a mastectomy.
Helene Schonbrun October 19, 2011 at 12:39 AM
For those of you interested in reading more about the study that has been referred to in my article and in a number of these comments -- http://health.webmd.com/cgi-bin21/DM/t/nBPvH0OGeXc0Fv0Eh3O50ET
Hadara Sacher-Zemel October 31, 2011 at 04:21 PM
Adam, I think you've mistaken this for some other blog. This discussion is not academic, but rather emotional, psychological, practical and informative as a layman's blog often is. I'm not clear on what you are gaining by arguing an argument that has nothing to do with recommendations, professional practices and the ongoing argument of when to begin getting a baseline mammogram and follow-ups. Helene presents her blog as her own personal journey and the choices that were laid before her and why she chose the options she did. I find your arguments too clinical and devoid of an understanding of the emotional ramifications that influenced her choices, and her very personal experience concerning her illness. I would applaud her no matter what choices she made. And you would do well to lower the academic wall that blocks you from understanding human emotion. I'm sure you're a very nice person, but I have to say, you got it all wrong here.
Bongaloo October 31, 2011 at 05:04 PM
I didn't know this blog had a specific format. I didn't know this was the emotional blog. If Helene had good success with her treatment, I think that's excellent. The problem with the breast cancer coalition is that there is a lot of misinformation based on assumption. The public is lead to believe that early diagnosis means more cures. This is not necessarily true. The NY Times has a blog for "lay people" that addresses this very well. http://well.blogs.nytimes.com/2011/10/24/mammograms-role-as-savior-is-tested/ is the link. When the scholarly academics provide recommendations based on data, it is not appropriate a fund-raising organization to dismiss their findings simply based on its own agenda. Early diagnosis does not necessarily mean better treatment or better outcome. This is contrary to what we are led to believe. We have to look at facts, not opinions. My discussions are academic. Cancer screening and treatment has to be based on scientific data. You wouldn't want to put your care in the hands of a doctor who would say "I have no idea what to do. I don't read textbooks or scientic studies. Let's try this treatment and see if it works." I wish Helene success with her treatment. But I think my "argument" is clearly based on professional recommendations and practices.
Helene Schonbrun October 31, 2011 at 05:32 PM
The US Preventive Services Task Force study that Adam is touting gave recommendations that WERE NEVER ADOPTED. See this link for an article that pokes holes in this study http://health.webmd.com/cgi-bin21/DM/t/nBPvH0OGeXc0Fv0Eh3O50ET The NY Times article that Adam shares a link to measures whether women have been "helped" by a mammogram ONLY IN TERMS OF SURVIVAL. So it negates any value of finding a cancer early -- because I found mine at a VERY early stage, I did not require chemo (chemo itself puts you at higher risk of getting other cancers), and I have an excellent prognosis. Gosh, there certainly is value in that.
Hadara Sacher-Zemel October 31, 2011 at 09:27 PM
If that's the case, Adam, then I ask you again, why are you trying to turn one woman's story into an academic discussion?
Hadara Sacher-Zemel October 31, 2011 at 09:31 PM
Helene, I have so much respect for you. Your eloquent blogs and the amount of research you have done for yourself only serve this community, allowing us to connect with how our friends, moms, and sisters FEEL and how to approach them and their illness. The world needs more women like you, who can really get to the nitty-gritty of how breast cancer impacts their family and speak loudly about it so that the rest of us might just learn something.
Bongaloo October 31, 2011 at 09:36 PM
In response to Hadara....I am thrilled that Helene had a successful outcome. But she made the comments: "A mammogram had saved me from chemo, and had possibly saved my life. There is absolutely no question that mammograms save many lives." in her original post. It is certainly valuable if the mammo saved her from chemo. But did it save her life? How could I possibly know if it did or did not save HER life? But her comment it absolutely saves many lives is questioned. I do not claim to know the answer. But it isn't an absolute anything. Shirley said test everyone no matter the cost. That is her opinion. There are differences of opinion. I am offering data and studies and alternate opinions. Saying that everyone has to have a mammogram because countless lives are saved by them is simply not an educated opinion. It is an emotional reflex to a potentially bad disease. People need to review the data, review the recommendations, and determine their own conclusion. Nowhere in any of my posts did I recommend someone NOT get a mammogram.
Helene Schonbrun January 08, 2013 at 01:59 PM
Naomi, I've been writing about the breast cancer storyline on the tv series "Parenthood". So far 7 entries. If you would like to read them, click n my name at the top of the blog.
Helene Schonbrun January 08, 2013 at 02:01 PM
Hi Shirley, I'be been blogging about the tv series "Parenthood"'s breast cancer storyline. If you're interested in reading the 7 entries, click on my name at the top of the blog.


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