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Abnormal Mammograms! Ohmy!

[00:00:00] All right. It's still Breast Cancer Awareness Month. It's October and in honor again of the amazing Dr. Steve Cohen, the radiologist, who has helped so many women in my community. , including myself, who really tried to talk women through the anxiety of abnormal tests, especially abnormal mammograms. We're gonna talk about mammograms because a lot of this is mindset.

I'm not gonna go through all the basics of like, when do you start, what do you need? Who should be doing them? Because I believe all humans with breasts should be getting their mammogram screening. Different countries and different task forces will advise different intervals. Suffice to say, let's simplify and say anyone over 40 should be doing a mammogram.

that is simplifying it. There are nuances, um, and you might start as early as 35 or earlier if you have a strong family history. And just to note on genetics, please review your family history. Mothers, aunts, uncles, parents, fathers, siblings, children, breast, ovarian, colon, uterine, melanoma, [00:01:00] prostate, pancrea.

did I miss anything? Breast, ovarian, colon, uterine, prostate, pancreas, melanoma, seven. Familial cancers. There are more, but those are the big ones that it's good to know if you have in your family, not just breast cancer, not just ovarian cancer. We're finding, again, prostate can be related to breast. So it's good to know your family history and discuss it with your doctor to see if you're a candidate for genetic testing.

It's increasingly affordable and offers us an opportunity to find out more so that we can find and fix things. Also, please don't think or say things like, well, my mom had breast cancer, but it was the kind from hormones and she was older and now she's fine. As if that doesn't mean that that increases the chance a little bit.

I am thrilled. Your mother is fine. I understand that it might have been that she was taking hormones, but that doesn't mean that in the absence of hormones, she might not have gotten it. And the fact that she's fine is because she probably found it early. So you still should pay attention to those things.

Now, the reason I wanna talk about it today, on this [00:02:00] day, in honor of Dr. Cohen is once again, To remind us about how we can try to stay calm in the midst of such anxiety provoking world and news and everything. So with regard to your mammogram, I want you to know a couple of statistics, because going in for a mammogram is inherently nerve wracking, not to mention uncomfortable people who don't have breasts.

Just so you know, you have two like things that squeeze your. Now before we say like, I don't wanna do that cuz it hurts. It hurts a lot less than getting diagnosed with breast cancer. Anyone who's had breast cancer will tell you that. So please get your mammogram done and you need to know that it literally would take like each squeeze of your breast, which typically is two to three views in each breast.

Takes all of boo. What is that? I don't know. Four seconds. Radiologists, please weigh in and tell me exactly how many seconds it is that they squeeze and let go. Four seconds each, times two to three on each breast, you can do it. Okay, so statistics, the number of false positives is high, and that's not because, oh, it's a [00:03:00] terrible test.

That's because in the order to have a high sensitivity, meaning a test that will pick up the highest number of people who have any given cancer or issue, we need to make sure that we accept a certain number of false positives, false positives. You have a test that says you have something, maybe when in fact it turns out you don't.

Now, the important thing to remember is when you have an abnormal mammogram, it's not saying you have cancer. So that seems un unfair to call it a false positive in an onerous way, which fear mongers. So remember, if someone says you have an abnormal mammogram, they are not saying you have cancer. They are saying, we see something that we need to look into Further.

Estimates are anywhere from seven to 10% of all mammo. Will come back irregular, and that number is higher when you're younger because your breasts are more dense, you might not have other mammograms to compare to. So as you get older, the false positive rate will go down. But they've estimated something like, I think if you've had mammograms [00:04:00] yearly for 10 years of your life, your likelihood of an abnormal mammogram or a call.

which will most likely be a false positive, meaning you did not actually have breast cancer is this high as 50%. So it's good to know that. Does that mean it's not a good test? No, it means it's a test that is meant to have a high false positive so that we can pick up all the people who have breast cancer.

So first statistic is seven to 10% of your mammograms will be called back. So if I send a hundred women, I'm gonna call at least seven to 10 of them saying, Hey, gotta. I actually anecdotally think it's higher, but this is the statistics second statistic. Of those seven to 10% who need to be called back, they often just need to be called back for extra views and they will be fine.

But another about anywhere from it seems seven to 10% of those will need a biopsy. So pretty high number, right? Like in a, in a busy practice like mine, we're hearing people have biopsies all the time. Do I know that it strikes fear? Yes. Do I wish it didn't? Yes. Do I wish, instead of fear, we could say things like, Ugh, that makes me anxious.

I wish I didn't have to have a biopsy. But I know the statistics that [00:05:00] seven to 10% of women get called back for an abnormal mammogram. Seven to 10% of those women are gonna get called back for a biopsy. And of those biopsies, anywhere from 30 to 80%, depending on what you read, will be negative. So my net net likelihood of having breast cancer just from a callback for a mammogram is still pretty low.

And the best part about this is that if you do find breast cancer only on your mammogram without you palpating or feeling a mass, and you've been going for regular mammograms, which means it probably hasn't been there for two, two too long, then the likelihood is that you are finding it early. Now, does that not suck?

Yeah, it does suck here in the words you have got cancer do not ever sound fabulous, but hearing the words, you've got cancer, but we found it early and you're gonna be okay. Are all we can do at this point. Please, please, please humans with breasts. Please get your mammogram if you are in the right time zone, age zone, all the zones.

Talk to your doctor. Find out if you should [00:06:00] be getting your mammogram. Please know your family history and please remind yourself if you do get diagnosed, you are still likely statistically gonna be okay. Do the things you can to try to. The likelihood of getting breast cancer and acknowledge and accept that none of us can fully prevent anything and it is not our fault.

And by the way, even if you're doing all kinds of risk increasing habits, like eating crap, doing all the things that you might be doing to increase the risk of breast cancer. Even then I would say to you, don't feel bad or guilty. Reflect and try to do the things you can to reduce. And if you can't reduce those things, because these things are often addictions, then it's really of paramount importance to not beat yourself up and be guilty.

I say all the time, like when I was 250 pounds, I was doing the best with what I could. That didn't mean I shouldn't reflect and try to improve my health, which I have done, but that means me sitting. Being two 50, continuing to be food addicted and then beat myself up over it and [00:07:00] feel guilty was not going to be a value to anyone.

Not me, not my family, not the vibration of the world. Okay. Okay, so let us all honor Dr. Cohen again, radiologist extraordinaire who connected with so many humans over their radiology tests of all things. Let's remember to not have fear. Let's remember that nerves are normal, but there's no need for fear because fear is what we should retain for those times where we're being chased by an animal in the wild.

If you remember me saying that, all right, ask me your questions. Tell me where you think you disagree. That's all. Bye.