PRIVATE AND CONFIDENTIAL

PRIVATE AND CONFIDENTIAL is how you get letters addressed to you from an NHS healthcare provider. The NHS provided me with healthcare in 2011 when I blogged my breast cancer in I like it in the glory hole. I had cutting (an operation), burning (radiotherapy) and just in case therapy (adjuvant aromatase inhibitor - drugs to stop oestrogen, just in case any oestrogen-positive cancer cells remain). About a year ago, I made "a uni-lateral decision" (quotes because that is what my NHS GP wrote to the consultant) to come off the aromatase inhibitors, becoming one of the 36% who stop taking the drug by four years. Last week, five years after the BC, I had a write-you-off (discharge) letter,

"Thank you for attending for your recent mammogram. I am pleased to inform you that your mamograms (breast x-rays) show no sign of breast cancer."

So that's it then.  No more annual mammograms. Well that might be it.  I do have calcifications and apparently calcifications can lead to BC.  We'll see. In the meantime, I shall continue confidently trusting a private GP.

Cancer statistics

Did I have cancer? Am I a survivor because that routine mammogram in February found the tiniest lump, diagnosed it as cancer and I had local treatment (operation & radiotherapy), followed by systemic treatment (these nasty anti-hormone tablets). I reasoned that it was such a small lump that it wouldn't have been feel-able for at least a year, and then some. So with treatment at that stage I'd certainly have lived longer than five years from last February. Now I've had the diagnosis and the treatment, of course I'm told I'm likely to survive five years and the survival statistics would look good, but I would have survived those five years anyhow!

Now there's a debate about routine mammograms resulting in over-diagnosis, consequent over-treatment and survivor stories that encourage greater take-up of mammograms. Here's the original research from America, in the Archives of Internal Medicine. Note that the authors, Welch & Frankel conclude:
"Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or overdiagnosed."

Perhaps I don't need to keep taking these horrid tablets. I shall certainly argue this point with the oncologist at the next meeting in January. Perhaps it would be reasonable to stay on them only until the next mammogram in March shows that there are no more lumps. Last time I saw an oncologist, he said that if new lumps appear, it tends to be within the year or eighteen months after initial diagnosis. So perhaps I can come off the tablets after a clear year to eighteen months, instead of staying on them for five years.