In my last blog, I wrote about where I am now. What lies ahead for me?
With my ovaries and fallopian tubes gone, the focus turns to breast cancer risk reduction and screening.
Unlike ovarian cancer, there are reliable screening methods for early detection of breast cancer. Current American Cancer Society Screening Guidelines for a woman at average risk of breast cancer are:
- Women aged 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
- Women aged 45 to 54 should get mammograms every year.
- Women aged 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
- Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
Every woman I know in the appropriate age range gets annual mammographies. It’s routine for most of us.
Notice the lack of MRI screening for a woman at average risk.
For women with BRCA mutations, the guidelines are quite different. According to the National Comprehensive Cancer Network (NCCN), screening recommendations for BRCA patients are:
- Beginning at age 18, learn to be aware of changes in breasts.
- Beginning at age 25, clinical breast exam every 6-12 months.
- Women aged 25 to 75 should get an annual breast MRI with contrast (or mammogram if MRI is unavailable).
- Women aged 30 to 75 should get an annual mammogram (consider 3D mammography, if available).
- Woman aged 75 and older should consider screening on an individual basis.
In general, the screenings begin at a younger age, continue to an older age, and are more frequent and invasive.
My screening recommendations are an annual breast MRI with contrast, an annual 3D mammography, and a clinical breast exam every 6-12 months. That’s a lot of breast exams. I’m looking at this schedule for at least the next 17 years.
I’ve been re-reading that last sentence. I’m facing this screening regimen for the next 17 years at least.
The screenings themselves aren’t so bad. Mammography is painful, but the pain is fleeting. I can hold my breath for a few seconds and it’s over. For a woman who gave birth to 2 of her 3 children with no pain meds, honestly that’s not a big deal. I have a pretty high pain tolerance.
MRIs are uncomfortable but they are not painful. I described the procedure in depth in an earlier blog. The most painful part for me is the insertion of the IV for the contrast imaging. Again, painful but fleeting.
However, unlike mammographies, MRIs are quite time-consuming. The actual mammography only takes a few minutes. The MRI procedure, by contrast, takes an hour, give or take. Add to that all the prep time, and blocking off at least an hour and a half to two hours is not unreasonable. It’s also much easier to schedule a mammography. I’ve scheduled them before or after work, and even on weekends. MRIs, on the other hand, are more involved so the scheduling is much more difficult; they have always involved some time out of the office. My coworkers and boss would NEVER complain or hold me accountable for this but I don’t like to do it.
One more thing about screening. It is just that—screening. It’s not prevention or risk reducing. It just means that if I develop breast cancer, it will be found at a very early, and presumably treatable, stage.
So now that I understand the early detection screening that I’m facing for years to come, are there any options available that can reduce my risk or eliminate some of this screening? Yes. And that’s the elephant in the room.
cisforchaya.com 