Breast Cancer and Prevention, the Fear of Screening and How to overcome it

When choosing a healthy living routine, the goal is to stay healthy and live long. However, alongside meals with light and fresh foods, simple exercises to keep fit without excessive physical exertion, and extra attention to hydration, we need to remember that there is also another routine at the heart of healthy living. That of diagnostic examinations, which it is right to undergo at a cadence suggested by the family doctor. And to participate without fear or dread in the routine of cancer screenings. 

Mammography screening: no fear because it saves lives

This is not the case for everyone, but there are many who flee checkups and examinations because of the enormous worry of “having something.” The main fear is that of discovering a malignant tumor; mammography, among the female population, is among the most feared exams along with Pap smears, ultrasound and CT scans. The invitation to come to a specialized center for national mammography screening, which is free of charge and every two years, is often left unheeded by those who are in the target range between 50 and 69 years old. The risk of this fear? For those who avoid the exams is to overlook serious, and less serious, symptoms to the point of making them more difficult to treat or even incurable. Dr. Anna Abate of San Gerardo in Monza, who works in the Breast Unit and specializes in mammography screening, explained it well to us in this interview:

“Unfortunately, most women, do not have a clear understanding of the value and purpose of screening […] a valuable modality of diagnosis because it allows detection of lesions that are not yet clinically detectable. Most women still do not understand that the possible presence of a lesion that is not clinically palpable ensures the possibility of early intervention. […] But prevention must be done in another spirit: not as a condemnation but as an opportunity to detect lesions that are still very small with a low surgical, therapeutic, and therefore psychological impact and a better prognosis.”

Mammography: don’t be influenced by environment and experience

Why does fear block so many women and how do we overcome it? The first piece of advice is to start with a necessary distinction: fear dwells in our minds, while danger is present and concrete in reality. The fear of the results of cancer screening, such as mammography, is in the head, but the danger of cancer is well present with its burden of complexity and treatment. In fact, breast cancer continues to be the most frequently diagnosed cancer in women. But thanks to screening and increased awareness, it’s possible to dignosticate it at an early stage.

So what happens when the fear of screening is triggered? Psychologist and neuroscientist Lisa Feldman Barrett, in her book “How Emotions are Made,” explains that we don’t simply react to external stimuli, but we help create our emotions depending on our surroundings and our past experiences. So the idea of having a screening test for breast cancer, in a specialized center, with a doctor and mammographer invokes in many an extreme: if I do this test then I will find cancer and my life is in danger. It is called prediction: our brain is constructing a negative situation even when, in reality, that situation does not exist. And this happens based on memories of similar situations already experienced, such as, for example, someone’s account of an experience that has left trauma. In the case of mammography screening, the prediction is the testimony of women who have recounted discovering cancer this way.

But if we rationalize this, the reality leads us to an entirely different conclusion: an examination is being done to prevent a potential life-threatening disease, and therefore, even if there is an alteration or abnormality, action can be taken in time to increase survival. In the case of crippling fear, one must get out of one’s head and look at what is really there: doing prevention allows for healthy living and intervention. By its nature, mammography screening is a test that targets healthy people and is not invasive at all.

These directions are not a substitute for consultation and discussion with your physician, but are reported for informational and educational purposes only.