Mammogram Controversy

Last year my routine mammogram report came back as suspect and they wanted to do a follow up diagnostic mammogram.  it’s the same machine, same process only they get more angles, use a lens that can zoom in tighter, and there’s greater radiation exposure.

I didn’t do it.  I am skeptical about diagnostics.  Especially when I will bear the cost.  I have health insurance.  Always have.  But my very high deductible meant I’d essentially be paying for the diagnostic mammo.

Michelle Litvin for The New York Times A year after Monica Long’s partial mastectomy, a pathologist determined that she never had cancer.

I’m not saying that they were disease mongering but I do want to point out that mammograms are far from definitive.  They are up to interpretation. This New York Times piece, Prone to Error, explains and exposes the issue.

 

 

One million women over diagnosed and over treated new research reveals and further says that left alone, the cancers would not have been fatal if left untreated.

 

MY EXPERIENCE

My doctor really encouraged me to do the diagnostic.  Said I could go on a payment plan etc… But I also know that what they saw were tiny calcium clusters smaller than grains of sand.  Calcium clusters are normal but some times they like to gather around precancerous growths.

Notice all the hedging? “like” and “precancerous”. So did I.

So I did a little a research.  I asked if it was cancer would the course of treatment be any different now than 6 months from now?  No.  And if it was cancer, and cancer cells tend to proliferate quickly most of the time, isn’t possible that we’d see more of the clusters 6 months from now?  Possibly.

I decided to wait it out. Within a few weeks I got a letter from the hospital saying that I now needed a biopsy?  Huh?  I hadn’t even gotten the diagnostic.  I followed up and they said, oops, mistake. They jumped the gun to their next step in their standard of care.

ONE YEAR LATER, 2014
I go back for routine mammo and once again they see they clusters but I couldn’t get an answer to if there were more or fewer than last year. Just too small to tell apparently. They need to do a diagnostic to see better.

Things have changed under new affordable healthcare act.  My deductible went up but so did the rules according to what should be included as routine wellness care.  I called my insurance company which assured me that this diagnostic and other followups (ultra sound, needle biopsy) would be covered, no out of pocket, no deductible to meet.  This is part of my new insurance plan.  Hurrah, I thought.

Well you can guess what happened.  I got the bill. And now am working to figure this mess out.

Cost = about $500 per boob. They wanted to do both to have a comparison. I felt a little vulnerable naked in a paper gown so I agreed to let them do both sides.

RESULTS?
Inconclusive. Needle biopsy would tell more. Though she couldn’t say for sure in all likelihood there was nothing to worry about. I opted out of the biopsy.  Meanwhile they advised that in 6 months I get another ultrasound. At my age, tissue changes are very common.  Lots of fluctuating hormones.  There’s no breast cancer history in my family.

Diagnostics do have their place.  When warranted.

I share this tale to say that sometimes you have to take these diagnostics with a grain of salt. Use your own good judgement and do your research.  The practice of medicine is not perfect.  In the most cases, physicians do their best, to best of their knowledge.  It’s just not wise to abdicate all responsibility about your health to someone else.

The number one killer of women (and men) is heart disease.  My family does have a history of stroke and high blood pressure.  I’ve taken it upon myself to get cholesterol checked.  But I certainly don’t get solicitations to get yearly follow up tests for that or any other heart related issue.

Yet more people will die from heart disease than all cancers combined.

I’m just sayin’.

What can you do?  Here are 5 tips on how you can be more proactive about your medical care.

 

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