I just had to write about something I’ve been noticing lately. With Breast Cancer Awareness Month in full-swing, I’ve been attending luncheon after luncheon, seminar after seminar, speaking about my book Previvors. And the feedback has been tremendous: So many women have told me that, because of their family histories or other risk factors, they know they have to confront their risk. They agree with the book’s message that they have to take charge of their health. They have to turn their fear of breast cancer into empowerment.

However, I’ve also learned that many women are still so afraid of breast cancer (or so in the dark about it), that they are actually doing themselves more harm than good.

One woman, well past 40, actually told me she has never gotten a mammogram and she doesn’t plan on getting one any time soon. Her reason was that her family “just doesn’t get breast cancer.”  I explained to her that an overwhelming majority of women who get breast cancer have no family history of the disease. But she seemed pretty determined that mammograms just weren’t for her.

Other women are so afraid that the technologist will find something during the mammogram, that they’d rather bury their heads in the sand than deal with even the slightest possibility of breast cancer. I just don’t understand this logic. I have a dear friend who had a high risk for breast cancer. She was so petrified she’d find something that she skipped her mammogram quite a few years in a row.  Sure enough, breast cancer developed. She caught it too late. I miss her more than words can express.

I understand, there’s a lot of confusion about mammograms these days. Last year the U.S. Preventative Services Task Force started recommending mammograms at age 50 rather than age 40, and less often. Their reasoning was that screening women in their 40s leads to a lot of false positives, unnecessary biopsies, and anxiety. However, organizations such as the National Cancer Institute, the American Cancer Society, and Susan G. Komen for the Cure still recommend mammograms starting at age 40 (and even earlier for high risk women).  Mammograms are still the best screening tool we have, and they do still save lives.

I also understand women’s reluctance to have mammograms. They can be uncomfortable and sometimes even painful. And the stress of waiting for the results can be torture  (especially for high risk women or women who are having diagnostic mammograms for suspicious lumps.) Then, if the doctor recommends a biopsy, there’s even more anxiety and often overwhelming fear.

But what is the alternative? Avoid mammograms and play Russian roulette with your life? Or keep up with screening and, if breast cancer is present, catch it at the earliest, most treatable stage possible. If breast cancer is caught  before it has spread, the 5-year survival rate is nearly 98%. Personally, I’ll take those odds. I’d rather deal with a few minutes of discomfort and even an unnecessary biopsy than the unthinkable.

If she could do it all over again, I’m sure my friend would, too.