BarbaraHudson's Journal: No thanks, I don't want a mammogram.

The government came up with a new initiative to offer every woman a referral for a free program to screen for breast cancer, including followups and treatment. Got the invite in the mail Tuesday, and thought it was funny. I'm literally in the lowest-risk group.

Statistically, over a 20-year period, 73 cases per thousand will be detected, as opposed to 54 per thousand without screening. Makes sense. However, 10 women will be over-diagnosed (have a detected breast cancer treated that would have been harmless if ignored). Not so good. 1 in 100 over 20 years. Hmm.

Now for individual risk factors. There have been no cases of breast cancer in my relatives that I am aware of. That means that, while about 5-10% of the population of both sexes have the BRCA-1 or BRCA-2 gene, I almost certainly do not. Also, I don't have any of the "lifestyle diseases" that promote cancer.

And then there's the only complete longitudinal study of more than 4500 subjects like me over a 40 year period, with only ONE case of breast cancer.

So, over the next 20 years I have less than a 1 in 4500 chance of getting breast cancer, and a 1 in 100 chance of a misdiagnosis resulting in unnecessary treatment. And those unnecessary treatments carry their own risks.

So I made a few jokes about it, and put the letter aside.

The next day was an appointment with my gp. You'd almost think there's a conspiracy going on. After an examination that found my lungs work fine, my heart doesn't make any weird noises, there's nothing in my guts that feels abnormal when palpitated, my blood tests are ok (and you'd kill to have my cholesterol numbers), my blood pressure is within norms, what does she want me to do "just as routine preventative care?"

A mammogram. A bone density xray. A test for colon cancer.

Since this is the first gp I've ever had (saw her for the first time a few weeks ago, and the waiting list is LONG), I kind of don't want to antagonize her, so here goes for the useless mammogram.

Of course, when you get quacks like Dr. Mercola saying to avoid it, why not go for it?

Note: This guy is such a quack. Here's just one example:

As little as ten years ago, hormone replacement therapy (HRT) was believed to be safe, but has since been proven to drastically increase your risk of breast cancer.

One study made the startling discovery that HRT with either estrogen alone or estrogen-plus-progestin was associated with a 70 percent increase in breast cancer risk when the therapy was taken for five years within the six years preceding the cancer diagnosis!

This is also true for birth control pills. Theyâ(TM)re synthetic hormones which may even be worse than Premarin, so I strongly advise women to avoid birth control pills as well as traditional approaches to HRT.

Bioidentical hormones, which are a safer alternative, do not appear to contribute to breast cancer like its synthetic counterparts.

Who the hell still uses premarin (made from pregnant horse urine, cruelly obtained, not bio-identical, and containing some enzymes not found in human bodies)? The treatment of choice has been estradiol for a LONG time. HRT with estradial and without progestins lowers rates of breast cancer, osteoporosis, and cardiovascular disease, delays dementia, cognitive decline, Alzheimers, and takes at least a decade off your apparent age.

What's not to like?

And that advice at the bottom to sleep in absolute darkness? It's not natural. We didn't evolve for that. He seems to forget that there's these things called stars, and the moon. If sleeping in the dark is so necessary, how come we feel so refreshed, SO GOOD after an afternoon snooze, or sleeping under the stars with a sleeping bag?

He should team up with that other peddler of BS, Dr. Oz.

In the U.S.,...

[Bill Dawg]

...they started telling women they don't need screenings for things as often anymore. (Curiously, it seemed to coincide with the installing of Obamacare. But I'm sure that had nothing to do with it...)

The Left is doing that here probably for the same reason you're against it, over-diagnosis.

When all I want to know is whatever happened to personal choice in America. I live in this country specifically because I don't want my government advising me on how to live my fucking life.

Re:

[BarbaraHudson]

The thing is that in my case, the stats just don't apply. Male-to-female transsexuals have far lower breast cancer rates because they are generally exposed to estrogen at a later date, and nowadays progestins are kind of frowned upon for their associated risks from long term exposure (something hard for most women to avoid). Someone transitioning in their mid-30s has at least a 2 decade delay over the standard "start-at-50" practice - and we don't generally recommend screening mammograms for 70-year-olds.

I