Mammogram Required?

[Plink 0]

I'm 41 with no family history of breast cancer. I'm with Kaiser and they do not require mammograms at this age. I had done my research and decided to wait until I was 45-47 unless something happened sooner to make me feel like I need one. But the bariatric surgeon told me that I have to have one before surgery. I asked why, and the surgeon just said, "Because it's a life saving procedure." I told him that Kaiser doesn't require it and I talked to my OB and I decided to wait. He said, "Well, the program requires it."

I'm not trying to argue with them, because they are not making the process difficult for me, so I dropped it. And I scheduled a mammogram for this week. But, I can't stop asking myself WHY a bariatric surgeon would know better than my OB when I need a mammogram and why it would be required for an unrelated procedure. I don't like answers that are "because I said so" without any logic and explanation, but that's basically what I got from the surgeon. And I don't want to piss them off, because on my first appointment, he said I was at my pre-surgery goal weight, agreed it was medically necessary, and targeted surgery for my preferred date - early August. But, I also made an educated and medically advised decision not to have a mammogram yet, and it's really annoying me that I have to do it....

SO - does anyone have any insight on WHY, at a younger age, they make you have a mammogram before the surgery? Maybe I would be less irritated if I knew there was some science behind it...

Edited May 27, 2019 by Plink

[Briswife15 889]

I've never heard of a mammogram being required prior to surgery, but all surgeons are different.

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[CurvyMom 386]

I was 40 and didn’t have my mammogram before. I did have it two months after but it wasn’t required. I just wanted to get a baseline and since insurance covered it, I did it. Not sure why your surgeon wants it....maybe they are just crossing certain things off of a list they have and since you are of age to get one, they want it. I was a little uneasy about getting it done (nervous) but it was easy peasy. Glad I did it...

[KCgirl061 1,529]

The only reason I can think of as a possibility is if you did find you had breast cancer and needed chemotherapy. When people lose weight during cancer treatment, it is most often due to an inability to maintain good nutrition. Chemotherapy can sometimes cause nausea and a general loss of appetite, while vomiting and diarrhea can greatly impact your ability to retain nutrients from the foods you eat.

[49Nash 103]

I agree with KCgirl. I don’t as told you had to be 5 years cancer free to even be considered (I don’t have cancer they were just telling me all the requirements). If you were to need chemo you would have a very difficult time getting the required nutrition needed if had severe food restrictions. It wasn’t required but mine was due right before my surgery. I hated doing it because I didn’t want anything found that could delay my surgery but then I realized I was being ridiculous because I was talking about cancer which way trumps obesity!!

[GradyCat 3,692]

That doesn't make any sense to me

[catwoman7 10,845]

Not sure although your breast density changes a lot when you drop a massive amount of weight. There are a few women I know who've been WLS patients who've had call backs after mammograms after they lost all their weight because things looked a bit odd - although in all cases, it turned out to be nothing. Maybe he just wants a baseline?? At any rate, if he requires a mammogram for surgery, then he requires it - not sure you're going to be able to fight that one.

[notmyname 591]

No idea. I saw three different docs before I chose mine. One required a mammogram (I'd already had one, so it wasn't an issue). But that same doctor often answered questions with either "because your insurance requires it" (even when I knew full well it didn't) or "because I said so". Even though I'd done 3 of my 6 months pre-recs with him, I decided I didn't want a doctor who wouldn't explain things and outright lied to me, so I switched doctors.

[2Bsmaller18 435]

It doesn’t make sense to me however from an insurance perspective I would probably just do it. I would assume that you will end up paying your deductible etc this calendar year with WLS anyway so at least the mammogram would also go towards that. On the other hand a lot of younger women get false positives and have to get an ultrasound etc which ends up being a lot of unnecessary stress.

[Sandra Nuelken 419]

Nope, didn't have one either. Not required by my doctor.

[AZhiker 2,251]

No mammogram required for me. But.... my stress EKG showed something a little funky and I ended up having 2 nuclear exams and then ended up with the full cardiac cath! Thank goodness it was normal. I would choose a non invasive mammogram any day over having wires threaded through my heart!

[AZhiker 2,251]

Please know that in my previous post I was not trying to minimize the concern - or pass over a doc who won't explain things. Just trying to add perspective to some of the things we can't change. Like why some insurances require 6 months of pre-op supervision and others don't. My doc required the psych and nut consults, 2 classes, cardiac clearance, a zillion labs, and throw in a sleep study for good measure. Took me 8 months to get the check list done. Some docs don't seem to require anything - just sign and pay. Hopefully, we find compassionate doctors who will explain the rationale for what they order, but control of the surgery is in their hands, so we gotta do what we gotta do.

[Frustr8 7,886]

Got to agree with you there! Of course, when you get to be my age, almost every test has some sort of "caboose" to it; but I prefer finding these things out before I get to a High risk state. As an example:
Chest MRI to check my aorta- Renal cysts
Neck Cat Scan- thyroid nodules
Multiple endoscopies- Bowing of Vocal Cords
Repeated blood labs while PICC line in place- low blood iron- Iron INFUSION
DEXA scan- yearly INFUSION to stave off osteoporosis worsening
Mammogram- only one they found Nothing Else- what a relief!
And all of these since January 2019. Trust the bailing wire I'm fastened up with lasts! LOL😝

[othella2 76]

That has nothing to don't have anything to do with the surgery. Ask your insurance what you need to do and show the surgeon.

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[Plink 0]

SO, the insurance and surgeon are Kaiser. I will call Kaiser and see if it’s mandated for the program, but I think generally if the surgeon says it is, then they are going to make me do it.

Thanks all all for offering some ideas on this!