Dense Breast Tissue: You Are In the Market For a Mammogram
What is the truth about diagnostic tests, breast cancer, and treatment?
Thanks to my business consulting work, which often serves healthcare industry businesses, including healthcare tech, I get a variety of U.S. and international health newsletters each day.
Yesterday, MedPage Today sent an article entitled, “Dense breasts raise breast cancer risk, but many women aren’t aware — here’s what to know.” That headline didn’t turn out to be a link to MedPage Today. This header was the #1 article in MedPage Today’s Sunday morning newsletter and it goes straight to … wait for it … NBC News. You know: the second clinical arm of the Mayo Clinic, Johns Hopkins, or the Centers for Disease Control (CDC).
“I have dense breast tissue,” I thought.
How do I know this? Because when I went for my recommended mammogram in my early 40s, they couldn’t get a reliable image. The mammographer told me that I had dense breast tissue and might have to wait until I was older and my breast got more fat before the test would be effective in showing any breast cancer.
Of course, if I didn’t have breast cancer, it shouldn’t show that … right?
Flash forward to being about three years younger than the average U.S. woman with a breast cancer diagnosis and experienced in the way the U.S. media is used to drive calls to doctors, requests for prescription medication, and demands for diagnostic tests …
I am pretty sure that I just read an article that is geared toward making women like me frightened (“I have dense breast tissue!”) and call for a mammogram, driving an increase in these tests. According to a medical cost website, TalkToMira, I’ll be spending $187 if I schedule a private-pay mammogram in Florida and have no insurance. With health insurance, that will cost anywhere between $185 and $550. Florida has a breast and cervical cancer early screening program, so if I meet income requirements, I could get the test for free.
But Fuji, Hologic, GE, and Siemens don’t care whether women pay for mammograms up front, have insurance coverage, or receive a free mammogram through government or charitable sources.
You’re reading something written about women’s health by someone who had the first laser surgery for early cervical cancer given by Kaiser Permanente in Fontana, California — with her legs up in the air for half an hour and ten curious residents looking on. “Would you mind being part of a demonstration? Sure — no problem! … uh … wtf did I sign up for???”
Every day I see “medical news” in the form of a study that seems to be intended to drive people to sign up for more diagnostic tests, request additional prescription medication, or call their doctor in fear they’ll get — here are three recent ones …
MPox (the new name for “Monkeypox”)
The latest COVID variant
H5N1 — avian flu
After what we have been through with the COVID-19 pandemic, one would think that health authorities and journalists (I use this term extremely loosely) would have a renewed commitment to accuracy and responsible reporting.
But instead, medical and health news is crowded by industry-sponsored studies meant to promote specific diagnostic tests (like mammograms), specific treatments (any medication you care to name — as long as it’s still under patent), and research into the endless list of preventable non-communicable diseases that continue to spiral upward out of control, from Alzheimer’s to cardiovascular disease, metabolic syndrome, and cancer.
If every one of the approximately 80 million women in the U.S. over age 40 had a mammogram every year, this would equal $20 billion in revenue. The U.S. healthcare industry in general is a $1 trillion industry; roughly the same size as the U.S. armed forces.
And the end result of all of this expenditure is a growing number of people who are fat, sick, and nearly dead.
I am involved with health and wellness startups that want to make a difference: not in a mega-corporation’s bottom line, but in the health and well-being of humans.
On a societal level, the problem is extremely complex. There is nothing more personal to any of us than our health: physical, emotional, spiritual, social. The damage done to our environment by commercial and military activity is serious and significant. The damage done to our environment and our own bodies by commercial food producers and methods is extremely serious. The way we think about ourselves, our relationships to others, and how our society affects our own health in these varied dimensions is …
I never went back for another mammogram after the technician told me I had dense breasts and would need to wait. I received dozens of exhortations that I must get a mammogram from Kaiser Permanente as a Kaiser member, but they never removed me from their membership for declining this test. I did the same with the endless series of colon cancer poop tests they would send in the mail. Now I live in Florida and have Florida Blue and fortunately, they do not bug me at all (their computer system sucks — if it were better, I’m sure they would).
Do I believe I have a greater risk of breast cancer because I have dense breast tissue?
No.
Internationally, the efficacy of the mammogram has been questioned by extensive study and serious, ethical medical professionals. The question of whether mammograms really save lives is unclear. Even the American Cancer Society is informing the public that mammograms are “the best screening we have at this time,” but not infallible.
I just asked Google how many women were over age 40: the answer? About 83 million. And according to the CDC, about half of us, or 41.5 million, have dense breasts.
To me? These demographics mean that the prediction my dear cousin promised me after I breastfed my daughter, that my boobs would get like “two pennies in a sock,” hasn’t yet happened.
I do not believe I have a higher than average risk of breast cancer (based on my health profile, no family history of it, and genetic testing).
The article I read may drive a few thousand mammograms that would otherwise not have been ordered. If the “study” it’s based on cost a couple of million dollars, the ROI on this venture is probably about even.
But this doesn’t stop traditional purveyors of fear, pills, and pain from continuing their profit-making practices.