Mentally Wrestling with Mammography in the Fight Against Breast Cancer

Just before Pinktober started Boston Globe correspondent, Kara Baskin wrote an article in the parenting section titled, “For many women, getting a mammogram is a mental health trigger.” Beneath that was this: “Screening is framed as self-care. But let’s acknowledge the anxiety, too.”

She outlines some very frightening statistics from the American Cancer Society about how over 280,000 new invasive breast cancers will be diagnosed in women in the United States this year alone. In addition to that staggering number over 50,000 women will be diagnosed with DCIS (ductal carcinoma in situ) and another roughly 43,000 women will die from the disease.

After Katie Couric’s public announcement of her diagnosis and the beginning of breast cancer awareness month, more women are being urged to go out and have their annual screening breast imaging. We encourage preventative screening and surveillance no matter what month of the year, and regardless of which celebrity just got diagnosed, because it is important and early detection does save lives.

Kara points out in her article that it’s not as simple for many women to just come in for their 7 minutes of grab and squeeze. There are barriers to care that exist that we as healthcare providers cannot see and ones that patients often feel too shy to disclose. Panic, fear and stress can be crippling for some people. Baskin outlines that, “there are 264 million people worldwide with anxiety disorders,” and while they vary in severity, there can be a very real feeling of dread and doom associated with coming in to a breast imaging center for a mammogram. Health anxiety is real; it makes us come to terms with our own mortality. We are very good at stressing ourselves out and spiraling to the worst case scenario. Simply scheduling a mammogram should not be the precursor to choosing a casket but some of us go there…

Often statistics are used to scare people into coming in for imaging; “1 in 8,” is likely a figure you’ve encountered before when discussing breast cancer odds. Even the way cancer screening and cancer care is marketed can be downright terrifying. We see and hear stories of individuals in our own communities and celebrities who are fighting cancer. Providers overshare stories of young people being diagnosed and send patients into panic when they have to now wait to schedule imaging; worse yet, wait for the results.

What we want you to know is that while the potential for breast cancer exists for EVERYONE who has breasts, the majority of us are going to live life without ever being diagnosed. It is not a gamble that we should be willing to take as technology has afforded us the luxury of being able to take steps toward prevention and early detection through tools like mammography, ultrasound, MRI, genetic testing, etc. In today’s advanced world we should not be dying of breast cancer.

I belong to several social media groups for breast cancer awareness and the amount of fear and tactical scaring being utilized in them is alarming. Self-proclaimed doctors are recommending biopsies when worried young women are posting their benign (noncancerous) results on Facebook or Reddit forums because their real doctors didn’t take the time to explain anything to them. Even worse, we take to Doctor Google or YouTube, MD to try to sort it out for ourselves – please don’t do that, you’ll find six other fatal conditions that you didn’t know existed but are now convinced that you have. The stress that you cause yourself is probably worse than the mammogram itself. Even Baskin acknowledges the irony, “anxiety about our health can actually undermine it.”

Cancer screenings are promoted as self-care, but they are not the same as getting a massage or meditating. People avoid mammography for multiple reasons. Some claim that the exam itself is too painful to endure, some have had sexual trauma, some hold a deep rooted sense of mistrust in the medical system, others simply cannot put themselves in the vulnerable position of waiting for a radiologist to interpret images and their doctor to explain those results.

Yes, the statistics are scary. Yes, you will probably have to wait for results. Yes, there is a possibility that you’ll be called back for additional imaging and sometimes even intervention. Yes, there is a chance that you will be that one (in 8) that develops breast cancer. The choice of whether or not you find out about it is yours alone to make. We know the unknown is scary, we go through it too.

If you have a question, concern, fear that needs to be expressed – call your imaging center or provider and talk about it. Believe me, you aren’t alone. Those of us working in the field would be happy to talk with you for a short while about what we can do to help you through the process so that we can take better care of you.