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The new mammogram guidelines don’t make our lives any easier

When you are high risk for breast cancer, every new development and recommendation is a cause for research and introspection. So the new guidelines just released by the American Cancer Society are a chance to pause and reflect, especially for someone like me, who lost her mother to breast cancer at 45 and is now nearing the age where I am considering my first mammogram.

The new breast cancer screening guidelines from the American Cancer Society have changed the age they suggest women get their first mammogram from 40 to 45 for women at average risk for breast cancer. The new guidelines also recommend that women go to every-year screening only after the age of 55 (as opposed to 40).

I am sure a million women across the country sighed in relief. But not me.

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For me, a person in the “higher than average” risk category, these new guidelines only cause more confusion. I am about two years out from 40 at this point, and the breast specialist I see, who gene tested me a few years ago, told me I should get my first mammogram at 38. But I have also read that the radiation from a mammogram, especially the buildup of yearly ones over time, can raise the risk of breast cancer.

There are people who believe that is hooey and that all this mammogram advice is influenced heavily by insurance companies who don’t want to pay for the expensive procedure. But I saw it with my own eyes. My mother went in for her first mammogram at 40. Two weeks later, she found the (rather large) lump that turned out to be stage 3 cancer that ultimately killed her five years later.

I am not saying the mammogram killed my mother. There is no way of knowing that and no way of knowing what part of her treatment should or shouldn’t have been changed or whether any of that would have had an impact anyway. But the legacy this confusion leaves me is a complicated one. My biggest fear in life is leaving my children early or dying the way she did. But not knowing what caused her cancer or how she could have detected it earlier doesn’t help me in any way.

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I currently have the prescription my doctor gave me for my early mammogram at the top of my to-do pile. I was supposed to call after I’d finished nursing my third (and final) child. But I can’t bring myself to dial that number. Maybe it’s because I don’t want to face getting older. But also it’s because somewhere, in the back of my head, I do wonder if my mother’s mammogram helped her or hurt her.

It’s taboo to say among breast cancer survivors who feel the opposite way (and often feel it strongly). I don’t question that early detection saves lives. But I do wonder if mammograms are really the best possible way to find early cancer.

These new guidelines are confusing me even more. So what is a person with my risk supposed to do? At some point, I suppose, one just takes the leap and makes a decision and follows that road through to the end. But I am not there yet. I have seen the reality of metastatic breast cancer. I have seen everything it can take away and destroy. I don’t ever want to have to face that myself.

But these kind of guideline shifts are confusing. And scary. My fear is that women like me will do nothing. We will sit on this information so long without forcing ourselves to make a decision, and then when we finally do, it will be too late.

I might call and make that appointment. I might not. But no matter which way I go, even a clean mammogram won’t stop my fear. I will never forget that my mother had a clean one too.

Do you trust mammograms?

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