Breast cancer risk? You tell me....

My mum , Jeannie Morris

So-another week ; another debate about breast screening, and whether it causes more harm than good.

An independent review into the value of mammograms  reportedly showed that for every life saved, three women had treatment for a cancer which would never have been fatal.

That treatment might be radiotherapy, chemotherapy or surgery; all with their own side effects.

More information for women will now be made available apparently; to help them make an informed choice. The national cancer director, Professor Sir Mike Richards is quoted as saying this issue has become an area of `high controversy`.

You bet your life it has, Professor.

But should I bet mine...by attempting to make my own decision about the course of treatment I should have, if a little undiscovered planet is spotted in that galaxy of stars on the radiologist`s screen?

The answer is--I don`t know. It`s like the heating engineer telling me my boiler might last another year; might not. But with a £500 overhaul.....I`ll definitely stay cosy. Or a car mechanic offering me a temporary fix,or a brand new engine to be on the safe side. Who knows?

But as far as breast cancer goes; I know too much. Mum was one of six sisters. Four of them developed breast cancer; three, including mum, died from it. Each was given the facts, and made decisions about their treatment as best they could.

The two eldest had the recommended mastectomies. One died, one went on to have a second mastectomy and has survived into her eighties.

The youngest of the six sisters watched it move through the family, and opted for a double mastectomy and reconstruction; a course of action a cousin of mine has chosen as well.

Mum wasn`t on a screening programme--she spotted her own cancerous lump at the age of 48--weeks before she was due to marry a man whose first wife had died...from breast cancer. She had her own decisions to make about her treatment, and even whether she should go ahead with the wedding. She opted for minor surgery and radiotherapy; and the wedding. Not the mastectomy that doctors suggested would have been a safer course of action.Was she right?

You can only give patients advice and ultimately leave the decision to them. I don`t doubt that what her husband-to-be had gone through, swayed her decision. But did it kill her? Should she have gone for more radical surgery to try and eliminate the risk? They had seven years together before the cancer really took an aggressive turn, went on the march, and despite every possible form of treatment available, included the mastectomy she`d tried to avoid, mum died .

My family history means I was lucky enough to be offered a place, some years ago on a clinical trial which compares mammography with MRI scanning. And then to be offered annual screening.

And then suddenly, we were talking about my generation. Last year`s scan spotted a little blip on the radar; a condition called Ductal Carcinoma in Situ. I tried to focus on the `stuck in a duct` bit, rather than that `carcinoma` word, which no one wants to hear. I had surgery to remove the affected area and some tissue around it. Then there were three weeks of intensive radiotherapy; which for the most part involved me sprinting in and out of the treatment centre in running gear and trainers. My brain told me I was *fit*; so I shouldn`t be there. The staff were brilliant. I was, compared to many waiting for treatment, completely blessed, but I hated every second and couldn`t bear to meet anyone`s eye, wearing shades most days in the waiting room, and flinching when someone called out my name. I kept the treatment a secret from all but my closest friends and colleagues. That meant carrying on working full time as a breakfast show producer, getting up at 3.30 am.

After it was over, with just a three inch scar and some tiredness, all I could feel was immense relief and good fortune: it was a high grade `blip` caught before it had invaded the surrounding tissues--at which point, apparently, I would have been advised to have a mastectomy. Would I have gone ahead with the surgery? I truly don`t know.

I know plenty of women whose cancers were found early, and who are quite sure they owe their lives to screening, and in some cases to the treatment that followed. Cancer charities seem to be recommending that you go ahead with screening if you`re called for a mammogram under the national programme.

And then, increasingly, you`ll have to make your own decision about anything they find. If you`re waiting for an incisive,well considered conclusion to all this--I don`t have one.

If the oncologist I`m booked to see in a couple of weeks,or any other doctor in the future finds something wrong with me, I want to be treated like the intelligent human being I am, to weigh up the options and statistics, and help shape the events that follow.

But --and excuse me for sounding weak here--a part of me still wants to say hey..do you know what? You`re the one in the white coat. I`m crap at stats. I truly have no idea. Please decide for me.

bbc.co.uk/health

cancerresearchuk.org

breakthrough.org.uk