I’ve been invited for my first mammogram aged 41

[JRHartly]

Hi all, I’m 41 and I was very surprised to get a text from my GP inviting me for my first mammogram. I had always assumed they would start when I am 50 or 55 so had never really thought about them.

I just wanted to get your views on whether this is the norm now and if you would get the mammogram or wait a few more years. Some points that may or may not be pertinent:

• my dad’s mother died of cancer (in the sub-continent) but I don’t know what kind of cancer, a couple of relatives have said it may have been breast cancer, but can’t say for sure
• my father died of pancreatic cancer
• I’m terrible at self-exams, I put them off as it makes me anxious (think it might be related to my ADHD)
• I’m Asian

Thanks everyone.

YANBU: get the mammogram
YABU: don’t get it now, wait until you’re 45

Hi,OP —

I have dense breasts and I have never found mammograms to be worse that a bit uncomfortable. I write this as someone who finds smears painful.

Please take this opportunity!

With screening, there is a tendency to apply emotion rather than logic. More is not always better.

This is what Macmillan say:
Why younger women are not usually screened
Younger women aren’t routinely offered breast screening through the NHS Breast Screening Programme in the UK. This is because large research trials have shown that regular screening for younger women is less effective than it is for older women.
This is because mammograms, which are used for screening, are less effective at detecting breast cancer in women who haven’t reached the menopause. On average, the menopause happens around the age of 50. After menopause, the breast tissue is less dense. This makes mammograms easier to read and the results more reliable.
Younger women with an increased risk of breast cancer because of family history are usually offered screening with a newer type of mammogram called a digital mammogram. This is better at detecting changes in denser breast tissue (see the section on mammography below ).

and here’s the full link: www.nhs.uk/ipgmedia/National/Macmillan%20Cancer%20Support/assets/Breastscreeninginwomenunder50withafamilyhistoryofbreastcancer(CB).pdf

Up to you. Go, if you want to. But also know that they are not compulsory - at any age. Just reply if you don't wish to attend, and they will probably get you to sign a form which means that you are taken off the list.

I can't think of a reason not to have screening, even if it is uncomfortable.

Reasons:

• Overdiagnosis
• Radiation exposure
• Lasting negative psychological effects of false positives

For those who like their science, here is the Cochrane review, the gold standard of evidence-based medicine, on the subject. They estimate that for every woman who receives life-prolonging treatment, ten women are diagnosed and treated unnecessarily and 200 experience significant, unnecessary psychological distress.