Has anyone decided not to go for a routine mammogram?

[hattie43]

I'm curious to know . I have mine next week and will attend but last time was a nightmare as I was recalled and health anxiety went through the roof . Luckily no cancer . I was reading that about 30% of women don't attend Apparently mammograms don't pick up everything and aren't foolproof , but surely they are better than nothing .

@WiseUpJanetWeiss 🤣🤣probably
my fault for not quoting the entire post!

but thank you for the explanation!!

My sister in law died of breast cancer at age 43 and I can tell you it was way more painful than a mammogram. She was on liquid morphine and still in agony when she died. The pain (and I never found it painful) of a mammogram compared to the pain of stage 4 cancer is like comparing a paper cut to being run over by a train so I find this point of view extremely naive and sad.

@goodsea thank you so much for that information.

She died over 20 years ago treatments in all things have come on in that time....even in the 8 years I've been cancer free.....transplants, hear bypasses, birthing have all changed.

"Save them"- you know none of us get out of here alive in the end? And screening goes to age 70? We're not talking about thirty year olds with young kids here. At 69, something will kill you in the next 10-20 years. Some women will decide they don't want to waste time in those years being treated for something that they'll die with, not of. That's ok.

Whether screening "saves lives" is debatable at best.

No idea what you’re talking about here.

The proportion of women who are harmed for no reason is greater than the proportion who are saved following a diagnosis by screening. That is all. It’s all there in the leaflet. All you or anyone else needs to do is decide which risk you’re most comfortable with.

@LolaMoon and at age 43, your sister in law is unlikely to have been offered screening unless she was at higher risk, so is irrelevant to a discussion on screening.

I'm sorry for your loss.

I take up screening for everything else (smear test, bowel etc) but not mammograms. I have had one mammogram in the past, and it's not an issue about pain etc.
I spent some considerable time reviewing the studies and broadly came to the same conclusion as @WiseUpJanetWeiss - that the risks of overtreatment far outweigh the benefit.
The problem is that few women who have been treated will ever believe anything other than that their treatment 'saved their life'. The mammogram programme in the UK was heralded as amazing and life-changing, but actually it's flawed. Problem is some many people/charities/ hospitals were so totally invested in it that it was sacrilege to question it.
There are ethical issues as GPs are incentivised/paid to get women to screening.

Not sure if this article has been shared yet:
www.theguardian.com/society/2022/jun/09/overdiagnosis-some-breast-cancer-treatments-may-have-been-unnecessary-study-suggests#:~:text=8%20months%20old-,'Overdiagnosis'%3A%20some%20breast%20cancer%20treatments%20may,have%20been%20unnecessary%2C%20study%20suggests&text=When%20Jenny*%20had%20a%20mastectomy,traumatic%2C%20had%20saved%20her%20life.

This comment from a GP in the BMJ highlights the issue:
www.bmj.com/content/365/bmj.l1409

And the responses:
www.bmj.com/content/365/bmj.l1409/rapid-responses

And it's worth reading this:
www.healthsense-uk.org/news/198-screening-stopped.html#:~:text=Screening%20services%20are%20also%20suspended,Italy%2C%20Scotland%2C%20and%20Australia.

The NHS/UK public health recognises that there are risks and benefits to this screening and provides information so that each woman can decide for herself.

www.gov.uk/government/publications/breast-screening-helping-women-decide/nhs-breast-screening-helping-you-decide

Nowhere on this page, or anywhere else that I can find, does it say 'you should have this test' and that strikes me as really unusual for government health communication. The blurbs say 'you are entitled to screening', 'you should be offered screening', but they never say 'you should have this test'. They say 'here are the pros and cons to help you decide'.

The NHS/Public Health do not know whether you would be better off having the screening or not having it. If they thought you should have it they would definitely say so.

Why then are women not allowed to opt out (or admit to opting out) without a whole load of emotional manipulation?

I agree @WiseUpJanetWeiss and that leaflet was sent to me for my first 2 mammogram invites, but not sent for the latest one. The invite just came with a letter saying that my GP practice supported mammogram screening - odd in itself. But I looked it up on gov.uk and it was still saying the same thing.

I have never been. I signed a form to opt out s few years ago, so I guess it's fairly common. Screening can lead to over-diagnosis and unnecessary treatment so I am willing to take my chances and just go with the flow. I also think screening has potential to feed hypochondriac tendencies, so it's just not worth the hassle.

@LangClegsInSpace i think a previous poster (sorry cannot remember who) had it on the nail regarding the emotional pile on, should you dare to admit to opting out.

Broadly speaking, if you’ve had treatment and survived, then you don’t want to face the fact that there was a chance you fell into a didn’t need treating in the first place group. Maybe then it’s a double down effect, of trying to convince yourself that you were right to go along with treatment and must reinforce that righteousness and convince everyone else they must go for screening?
Maybe someone else will have other ideas as to why there is such emotional manipulation.

Maybe someone else will have other ideas as to why there is such emotional manipulation

Any thread about screening (boobs or cervix) always brings out the emotional manipulation. Lots of posts about women who opt out being "selfish", or a drain on the NHS, not fair on their families etc (and like a PP said, not everyone has family that would give a shit). On social media, you see posts about if you can go and get your fanny waxed, then you should be fine with a smear... or if you are ok with a penis, you will be fine with a speculum.

With smears, I have known of women who said the screening saved their lives, when all it did in reality was pick up changes that might have gone away on their own anyway.

By the way, no medical treatment can "save your life", although it may prolong life, that's true. But - news flash - we ARE all going to die!
Let's just accept that this is a tricky subject, there are a range of views and it's not for any of us to judge people who may make different choices. Personal choice is a wonderful thing.....

NO!

You don't get the high emotion about statins, and the risks there are much lower than chemo, surgery, radiotherapy.

"If you refuse your statins you shouldn't expect treatment or neurorehab for your stroke!" "My mum died of a heart attack, I can't believe anyone wouldn't take statins for a few leg twinges. I never had pain, so they're probably lying anyway!" Said no one ever.

It's only screening regarding women, and specifically screening of women's sexual characteristics, that get the guilt, shame, emotional manipulation pile on. Why's that?

That should say disease prevention or intervention rather than screening, I guess, as stains aren't screening. But they're an intervention that is beneficial on a population level, that people make individual decisions about.

I'm pretty sure that Switzerland (and some other European countries?) are now de-implementing their breast screening programmes.

Professor Michael Baum was one of the original architects of the UK programme and has now become a fervent campaigner for its closure! I think he probably understands more about breast cancer than any of us.

This isn't a clinical source, but explains his point of view and you can do your own follow up research:
lizearlewellbeing.com/healthy-living/michael-baum-interview/

@XenoBitch @fairypeasant @Hbh17

thank you - all very sound reasons on all your posts.

Yep, statins are an intervention. If you don't take them, then bad things might happen.
With screening (and women's in particular), the popular narrative is that if you don't get a smear/mammogram, you will die from cancer.
Search for any thread about that on MN (especially on AIBU). I have seen a comment about someone who did not want a smear.... she was told that she should get her will sorted out.

I missed my last appointment.

I find them so painful and awful, I couldn’t face it.

I’m not normally someone that misses routine screenings.

my friend is one of the ‘over-diagnosed’. This also puts me off as she has been through a lot.

But it's not saying that it's saying of the cancers found 3 in 200 are cancers that would never have caused symptoms and needed no treatment....1.5%

No it isn’t. Go and read it yourself.

You have completely misunderstood the stats

Aah whatapickle, I was dreading my first one, absolutely dreading it as I too have very sensitive boobs and had heard lots of stories about how uncomfortable it is. I literally had sleepless nights worrying about it. However, I found a lump earlier this year and the choice was taken out of my hands (I am not quite 50 yet so haven't been called for my routine one).

I ended up having a trip to the breast clinic to check out lump and honestly it wasn't that bad! I got myself all het up before hand but I honestly wouldn't be bothered about having another one.