I should be feeling peaceful and relaxed, sitting on a terrace in Provence, surrounded by the soothing aroma of lavender. But I’m not. In fact I am seething.
Yesterday’s Daily Mail (I only bought it because they promised me a commentary piece promoting my campaign to reduce the age of breast screening, honest) ran the following headline: ‘Many women undergo treatment for breast cancer when they don’t actually need it, a major study has revealed. Routine screening - offered to all women over 50 - is being blamed and some experts believe it should be stopped.’
After this was an opinion from a woman who thinks that screening is wrong. Her qualifications? She’s a health journalist. Now most health journalists I know, understand a topic for as long as it takes for the research to go in the eyes and out of the keyboard.
By the time the pound-a-word cheque has arrived in the post, they’ve forgotten everything important. So, let’s list the ‘harm’ that breast screening does: anxiety at receiving a screening request, anxiety at a recall, the pain of biopsies…as far as I’m concerned, that’s harm worth suffering instead of presenting with metastatic disease.
Apparently many cancers are indolent, and do not need treatment. Picture the following conversation:
Surgeon: “Biopsies have shown that the shadow on your mammogram is breast cancer. We have no idea whether it’s going to grow or not, so we suggest leaving it alone for the time being.”
Patient: “That sounds like a sound strategy. After all, it’s well known that you can wait to see if a cancer is growing before you treat it.”
In rebuttal to this, they print an edited version of my screening article, entirely missing the point, getting my name wrong, leaving out the web address for the campaign, and - most heinously - choosing a horrible photo of me.
I understand that probably not every single case of breast cancer warrants radical treatment but it would be a brave, or possibly silly, woman who refuses treatment having been given the diagnosis. Even now, having had a mastectomy, reconstruction, seven ops in total so far, chemotherapy, hormone therapy, and having suffered complications such as septicaemia, I would be delighted if someone came to me and said: “I’m so sorry, Sarah. We made a terrible mistake, those thirteen tumours you had? Well they turned out not to be cancer after all.”
I wouldn’t mind, because it would save the six-monthly heartache of follow up appointments, and constant anxiety at any ache or cough.
Journalist Isabel Walker’s main reason for refusing screening seemed to be that with no family history of breast cancer, she fell into a low risk group. If she feels 1 in 9 is low enough risk, then so be it.
I sincerely hope that the NHS isn’t saddled with the additional cost of treating her, if, God forbid, she ever presents with advanced disease.
I didn’t see the article before it was printed, as mine was written first, for a separate purpose, but if I had had the opportunity to make a proper response, I would point out the following: I have a cohort of seven friends diagnosed in their 30’s and 40’s, none of whom had a family history of breast cancer. The two that chose to pay for private screening, had early stage tumours, and many years on remain fit and well.
Five had palpable disease and all of them had the majority of the axillary nodes involved at the time of diagnosis. Sadly, two now have advanced metastatic disease.
So for Anna, Mairead, Judy, Sinem and Lisa, please don’t abandon screening, let’s make it available to the younger women in whom there seems to be an epidemic of aggressive breast cancer.