Friday, December 12, 2008

My breasts, they are stupid; my platelets, they are adequate

I had a mission this week to gather up some test results and give them to another doctor, which meant of course that I read them myself. My platelets are adequate, a comment that means very little to me. I suppose it's good that they're doing their job but it sounds like they're phoning in their performance.

My breasts though, they're heterogeneously dense, an expression that is new to me. So I looked it up and was quite surprised.

Here's a quote about the efficacy of traditional mammograms for women with dense breasts from cancer.gov:

The sensitivity for women with dense breasts was only 55 percent for film mammography while the sensitivity for digital mammography was 70 percent. The overall rate of 70 percent is within the expected rate of detection.
So nearly half of all cancers will be missed in women with dense breasts. But that's not all. From this page:

Women with dense breasts have been shown to have a four- to six-fold increased risk of developing breast cancer; only age and BRCA1 and BRCA2 mutations increase risk more.
So women with dense breasts, and there are a lot of us, not only have an increased risk of breast cancer but quite a lot of those cancers aren't detected, even among women who are religious about their screening schedules.

This is also interesting, from an article on breast self exam:

Teaching women breast self examination is not cost effective, nor does it lead to improvements in survival from breast cancer, according to a large, 10 year, randomised observational study conducted in Shanghai, China (J Natl Cancer Inst 2002;94:1445-57)


And the final paragraph says:

Advice to women to undertake breast self examination was abandoned over 10 years ago in the United Kingdom.


That's bizarre to me because I read another article saying up to forty percent of cancers are found during breast self exam. Unfortunately I didn't bookmark that page so I can't refer back to it.

The whole thing was rather depressing. What exactly does work? I'd like something with a better accuracy rate, please.

I've got a mammogram scheduled for tomorrow. I hate them. Because I take the blood thinners to prevent blood clots I bruise like mad and there have been a couple of times my breast tissue has actually torn from the test. I don't think this is normal, btw, and if you're someone who has one scheduled I wouldn't worry about it. I think it's just because of the medicine I take. But it's not fun. It's quite painful and now I find out it may not be effective? Ugh.

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