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 .

Anecdotes aren't data. "It's only because we care"... That we don't respect women who look at the evidence and make different decisions to us. That is paternalism.

Screening is offered. It's not up to women to police whether other women take up that offer.

@MrsSkylerWhite no one has suggested women should reject screening. What has happened is that posters (including myself) have given their individual reasons for not attending screening. These reasons are unique to each poster and those based on science have been backed up by medical data - which is the same data and info provided by the nhs, the breast screening service and the uk government.

This is a thread for those who didn’t attend and not for why you did attend. Two very different threads. Maybe start a thread asking people why they did attend?

Sad to say, I do have to agree with Fairy - a lot of poster seem unable to understand what they read, or they deliberately ignore what is written to fit their own agenda.

I’ll happily support someone who wants treatment and accept that. and that is their right. But it’s also a womens individual right to make her own choices about her body, her health and her future. It would be nice if people could respect that. Sadly this thread says otherwise. Such a shame for 2023.

Agree with everything you said @Alphabet1spaghetti2 .

Paternalistic is the right word. A few posts above is someone justifying the pressurising techniques on here by saying it’s ‘worth it’.

There seems to be an inability to understand that there is no definitive right or wrong in deciding whether to take up a screening offer. Because it is or was right for individuals, others must be pushed into doing the ‘right’ thing too.

Personally, I find this such a finely balanced issue that I could not try to persuade another woman one way or another. It isn’t for me to try and talk someone into something that could lead to unnecessary and unpleasant treatment any more than it would be acceptable to try and dissuade them from screening that, yes, may save their life or avoid more difficult treatment.

I wonder if people would have a different take on screening of any kind if we didn't have the NHS funded by our taxes, and if everyone had to pay for their own treatment?

Possibly! But that’s a thread in its own right.

I wouldn't ever describe mammograms as painful or invasive. Momentary slight discomfort would be more accurate. I've had loads because I've had breast cancer. I'm shocked that anybody would not go for a service that may save your life. Baffling.

I find it baffling that you can read the facts - that you’re more likely to be harmed by screening than you are to be “saved” - and have no understanding that some women do not like these odds.

If I'd not had screening my aggressive cancer would probably not have been identified in time. I am extremely grateful for it.

@CementTrucker Exactly.

I have no agenda either way. This isn't a clear decision. I have at no point said women shouldn't go for screening. No one has said no women should accept the offer of screening. No one had criticised any women for accepting screening. All we've said is that some women understand the information, understand the risks of screening vs not screening, and decide not to attend. And that those women deserve not to be bullied.

I keep saying this - you are told if your cancer is aggressive and going to kill you. You know if treatment has saved your life

You do keep saying this. But you seem unwilling to accept that this being true in your case does not mean that Drs always know which cancers will be aggressive and which ones will not.

Some they have certainty about and others they do not. In the latter case they have no idea whether the harms of treatment will be worth it for individual women.

You know your treatment was the right thing and essential. Great. This is not always the case for all women. Do you think this is a lie, or can you genuinely not follow the logic?

I think the screening programme must remain for women who want it, but the coercion and belittling of those who do not and have a different attitude to risk must stop.

Oh yes, I am sure that you are and I am pleased for you too. But you can surely understand that other women are unwilling to accept the greater odds of being harmed unnecessarily?

It has to be a personal choice without anyone trying to shame anyone else. I would not like to see the programme ending for this reason.

I also think that attitudes towards screening depend on your life circumstances.

I had DD later in life. It has made me much more aware of my health. She is too young to lose her mother so I regularly have smear tests and breast and bowel screening. I feel that I owe it to her and to DH to take care of my health.

If you live on your own with no dependents you will probably have a very different view to me.

@RampantIvy exactly!!

As PP say, over treatment is based on the fact that historically we cannot tell with certainty which tumours will cause trouble down the line if not treated.

But this is changing. There is now a genetic signature for a class of ultra low risk breast tumours that can be managed conservatively. A Phase 3 trial from UC San Fransisco validating this approach was published about a year ago. (Possibly in the Journal of Clinical Oncology. I am in STEM but this is a minor interest. I cannot link on my phone.)

Many more of these genetic signatures codifying tumour characteristics are predicted in the near future. An agile and properly funded NHS would be able to make use of them. At present ours may not be able to.

People concerned about the risks from over treatment may want to stay alert to the genetic possibilities and to the state of play in the NHS.

To clarify, it always takes a while for Pase 3 results to work their way through to practice. But it is frustrating that it often takes longer in the UK than in our peer countries, sometimes much longer

It takes a lot of mental strength to say you don't want over treatment when you have "the big C!"

What about the children?!!!! What about your FAMILY.

Once you know, you can't unknow.

This is an issue with many types of testing.

Once you know for certain you have cancer, however slow growing, wouldn't that change your life? Change what keeps you awake at 4am?

There is harm simply from knowing.

I probably agree for myself, @fairypeasant My point was that for PPs who say the risk of over treatment is the reason they don’t want mammograms, solutions are being developed. Breast cancer rates increase into old age so no one should make a permanent decision against screening now because they are concerned about over treatment

I would much rather be over treated than under treated, if I had to choose, and I attend although I did not originally think that relevant.

but women with non aggressive cancers dont get chemo, so your whole argument falls down there

I am on chemo, and it is a risk, but a much smaller risk than the type of cancer I have

Our pushiness comes from a good place.

This in no way excuses it or makes it ok.

This is very interesting thank you.

Is it okay if they have one of their breasts cut off? Chilling attitude!

Overtreatment/ overdiagnosis means mastectomy or radio or chemo or treatments such as tamoxifem or combination.

Here's what some women thought when they were asked what they thought about their unnecessary mastectomies and other treatments, there's a table that shows the treatments they had.

bmjopen.bmj.com/content/12/6/e061211#T1

women are told how aggressive their cancer is, and all treatment is optional

For me personally it's a decision I might revisit in my 60s, but by then I expect treatments to have advanced as well and quite likely the mammogram screening programme won't exist in its current form anyway - a more personalised risk based system in place instead.
I'd probably go private though (mind you I expect it will be paid service by then anyway)

Read women's experiences and see if you can empathise with how it feels.

And tbh, a lot of women don't appear capable of understanding what they are told, much like they don't seem to understand the leaflet, or know what overtreatment means.