Buzz
October marks Breast Cancer Awareness Month, but the truth is, we’re already familiar with breast cancer and the role mammograms play in detecting it. Amidst the sea of pink ribbons, let’s shine a light on some crucial realities that need more attention:
Mammograms Aren’t as Essential as You Think
While mammograms are vital for detecting potentially deadly cancers, they can also yield false positives, leading to unnecessary scans and biopsies. Additionally, they might expose you to the full cancer treatment experience for slow-growing or non-threatening tumors that don’t require intervention. Simply put, mammograms aren’t a case of ‘the more, the better.’
According to the US Preventive Services Task Force, you should begin mammograms at age 50 (unless you have a strong desire to start earlier) and continue every two years until age 74.
Different organizations have varying recommendations. The American Cancer Society suggests starting at age 45, while the American College of Radiology and the American Congress of Obstetricians and Gynecologists recommend beginning at age 40. Each group also has differing views on how often you should get mammograms, with options ranging from yearly to every other year or a combination based on age.
The USPTF suggests you may stop getting mammograms at age 75, citing insufficient evidence to recommend either for or against screening beyond that point. Other organizations propose different cutoff ages, but generally, the rationale is that there’s little value in detecting breast cancer if you're more likely to pass away from another cause first. The American College of Radiology believes you should stop if you have less than seven years to live, or if an abnormal result wouldn't lead to any actionable treatment.
Not Everyone Sees Their Cancer as a “Battle”
While no one wants to be seen as a 'victim' of cancer, the language of cancer as a 'fight' can sometimes feel empowering. We say a person is 'fighting' cancer or that they are a 'hero' or 'trooper.' If they pass away, we often say they 'lost their battle.' However, many people diagnosed with cancer don't feel comfortable with this metaphor.
When we call someone 'tough' for beating cancer, it unintentionally implies that those who died or whose cancer progressed weren't strong or active enough. Many cancer patients find the notion of being labeled as someone’s 'hero' uncomfortable and even unfair.
A UK charity, Breast Cancer Care, asked individuals who had experienced breast cancer what terminology they preferred. Here are a few recommendations that avoid using war-related metaphors:
Vicky shares her preference: 'I prefer phrases like “living with cancer” or “recovering from cancer treatment.”'
Susan mentions: 'I simply say that I’ve had breast cancer treatment, and now it's over. I don't want to be defined by the illness.'
Caroline prefers to keep it straightforward: 'I prefer to say things like “I’m undergoing cancer treatment” or “I’ve been in remission for three years, and it’s a relief to reach that milestone.”'
The cost of cancer treatment is extraordinarily high.
Even if you detect your cancer early and 'fight' the 'battle' as expected, steep medical expenses will still be waiting. A study of women with private insurance—that is, insurance obtained through your employer or bought independently—revealed that women under 45 accumulated $97,486 in extra medical costs (including those covered by insurance) within a year of their diagnosis. Women aged 45 to 64, who were more likely to catch their cancer early, had an average cost of $75,737.
A prior study on patients treated in 2010 (before the Affordable Care Act) also found the costs to be staggering. A significant gap existed between the amount the insurance company would cover and the actual cost of treatment—averaging $15,000 for stage I/II cancer and $50,000 for stage IV. (Out-of-pocket expenses for patients should be lower now, as the ACA made it illegal for insurers to impose caps on total benefits.)
Even today, cancer patients still face plenty of costs in the form of copays, deductibles, and coinsurance. Half of Americans would struggle to afford a $100 emergency, let alone the thousands that cancer patients must pay out-of-pocket.
Cancer charity PinkFund conducted a survey among women who have experienced breast cancer, whether recently or years ago, asking where they found the funds to pay for their bills. The results are shocking: 47 percent tapped into their retirement savings, 26 percent added to their credit card debt, and 41 percent skipped medication or treatment to save money. Meanwhile, 23 percent worked extra hours to earn additional income, but 36 percent lost their jobs or became unable to work.
These costs are likely not what you envision when you watch a cheerful, pink-hued commercial encouraging you to get a mammogram, but they are an unfortunate reality for many breast cancer patients. While we promote awareness and urge people to get checked, it's also crucial to remember that cancer brings along significant medical, emotional, and financial challenges.
This post has been updated to clarify that the USPSTF recommends mammograms only up to age 74, and after that age, they neither recommend for nor against screening.
