Home

Mammogram call back stories UK

Breast screening - getting called back after a mammogram. Some women (about 4 in 100) are called back to a breast assessment clinic after their mammogram. This is because screening suggests further tests are needed. This does not necessarily mean there's something wrong - 3 out of 4 women recalled have normal results after attending the. Recalled after routine mammogram. 4 Sep 2018 22:46 in response to Leicslady. Well that's the first stage done. This is the worst bit now, waiting for the results but you're doing the right thing. Going away for a few days should be mentally relaxing and hopefully you'll feel less drained when you get back Hi everyone, 5 weeks ago i had routine mammogram after 4 weeks i had a recall letter saying that they want to do further investigation, so you can imagine what i was going through ( same as everyone VERY ANXIOUS), i am a nurse worked in cancer services long time ago. when i went to my appointment they did repeat memmogram, then was called in. Three weeks ago, I received a 'call back' after I had my annual mammogram. The woman who called informed me this was very common, and they simply didn't get a clear image September 22, 2020. Getting called back after a screening mammogram is pretty common but can be scary. But getting called back does not mean you have breast cancer. It means that the doctors have found something they wan to look at more closely. If you get called back, it's usually to take new pictures or get other tests

Breast screening - getting called back after a mammogram

Mammogram Call Back. Last week was one of the scariest experiences of my life. It should have been one of the best weeks of my life after being featured in Detroit Home Magazine. However, it quickly changed after 1 dreaded phone call. I feel compelled to share what happened because I think (and hope) it will bring some comfort to women who. Called back after mammogram - but do not want to google. I had my first mammogram on Monday. I am only 42, but my DM's sister (maternal aunt) died from recurring breast cancer, so my doctor wanted me to start mammograms early. Anyway, they called this morning and asked me to go back in for further imaging, as they have found asymmetry in the. Subject: Called back after abnormal 3D mammogram. Anonymous. It could be a lot of things, OP. It could be a patch of what they call dense breast tissue; I had to do some repeat images for that. It could be a cyst, it could be something benign. You've done the most important thing, which is to go get a mammogram Thanks for the A2A. Having been on this journey, I can tell you that it needn't be as scary as it seems. The first step is another set of mammograms at a higher resolution, which feels the same as having the first one. There's no extra pressure an..

The call back did indeed come, only two days later. I am surprised to hear my doctor's voice on the line. Don't freak out, but they found something on your mammogram. Okay . Half of me is. The call back isn't a definite that there is something ominous going on in there. I'll share with you this article from Ask the Experts regarding the Mammogram Call Back where the writer sites some statistics that I found reassuring. Refer back to my reminders that again, ladies, this is why we put ourselves through this every year My First Time Getting a Call Back After a Mammogram. I've been very open about the fact that I'm a paranoid. My brain is wired such that my natural tendency is to think worst case scenario first, before I tap into my more rational, probability- and facts-based side. I see cough and fever and I think pneumonia Re: Recalled After Mammogram - Absolutely Petrified. There are a lot of people clearly worried sick about being called back for a second mammogram, so I thought I would share my experience, for what it's worth. I'd had several mammograms over the years and expected the most recent check to be clear, but it wasn't Call back and Follow-Ups. Following mammogram results after an initial breast cancer screening, there are some situations in which the doctors may ask you to return for another mammogram. A call back should be fairly immediate. A Follow-up is in 6 months, 1 year or 2 years. This post has everything you need to know about call-backs and follow-ups

Lots of women are called back for a second mammogram. But when I was told I needed additional testing - a diagnostic mammogram - I was terrified. You see, I had a 3D mammogram - also known as tomosynthesis or tomo, for short - and not by chance. I had heard about the new technology and decided to do a little research online Apparently mammogram callbacks are somewhat common. I read that, According to the American Cancer Society, about 10% of women who have a mammogram will be called back for more tests. But only 8. Getting called back after a screening mammogram is fairly common, and it doesn't mean you have breast cancer. In fact, fewer than 1 in 10 women called back for more tests are found to have cancer. Often, it just means more x-rays or an ultrasound needs to be done to get a closer look at an area of concern The Mammogram Call Back: It's no Audition. It's scary as hell. Mine freaked me out. I was fine with the mammogram because it was a routine test. But the call backwhat were they looking for? Since 1 in 8 women develop breast cancer, we need to be honest about the possibility of developing it. So, yes, get your mammogram

Recalled after routine mammogram Cancer Cha

  1. ation, more mammograms and ultrasounds. You may also have a biopsy, which is when a small sample is taken from your breast with a needle to be checked under a microscope
  2. The results of the mammogram will be sent to you and your GP no later than 2 weeks after your appointment. After screening, about 1 in 25 women will be called back for further assessment. Being called back does not mean you definitely have cancer. The first mammogram may have been unclear
  3. Original Artwork by Justin Carroll . As discussed in the BI-RADS article, many women are asked to return for additional imaging of the breast following a screening mammogram. In fact, 10% of all women undergoing a 2D screening mammogram will be asked to return for additional imaging (the percentage is lower with 3D mammography).). This is referred to as a call back
  4. The first mammogram result is called a false-positive result. You will not need to have any further tests or treatment. You will be invited back for a routine mammogram in 3 years if you are still of screening age. Many false-positive results are caused by tiny deposits of calcium in the milk ducts. This is called microcalcification
  5. According to a survey conducted by the Society for Women's Health Research, a whopping 47 percent of women who received mammogram screening will get a call-back for further testing. At the same time, up to 20% of all the tumors doctors will detect may actually be nothing at all or cases of ductal carcinoma in situ (DCIS), which is the.

The UK has a third jab in its immunisation arsenal, University of Oxford-AstraZeneca, which did not throw up lymph node swelling concerns in the study that led to its approval. Read more: One coronavirus jab 80% effective at preventing severe disease in elderly after 14 days As with all medicines, the COVID-19 [the disease caused by the coronavirus] vaccine can cause side effects, Addie. It's not unusual for women who've had a mammogram to be called back for a repeat test because of a suspicious result. You may be understandably frightened if this happens to you. But know this important fact: Most callbacks do not result in a breast cancer diagnosis. Often, abnormal areas on a mammogram turn out to be a noncancerous cyst or tumor Mammogram Call Back Reasons. Breast imaging surveillance is usually initiated for two main reasons: 1. The most common reason is to watch closely an area seen on mammogram, breast ultrasound or breast MRI. 2. To follow breast biopsy sites, confirming over time that there is no unexpected change SECOND call back...after 3D and then Ultrasound MAMMOGRAM. So my wife had her yearly mammogram early last week. She gets the 3D type as she apparently has extremely dense breasts. /she has been doing the 3D version for years now. Anyhow, she got the dreaded call back because an abnormality was found on her left breast According to the American College of Radiology, for every 1,000 women who have a screening mammogram, 100 will be called back for another look, and 61 will find nothing wrong after follow-up.

Getting a recall after a mammogram - Wommen Network

Re: Mammogram recall. hi Nancy, Yes, it certainly can be a false positive, but the mammo has done its job in picking up something that needs a closer look. Even IF it is a bc & it's your 2nd mammo, then it is likely to be an early diagnosis & easily treatable as I now realise, having gone through it sphil Sat 26-Nov-11 17:46:00. Am very anxious, as I have just had a recall letter 8 days after attending my first routine mammogram in a mobile screening unit. The radiographer there warned me beforehand that some women are recalled for technical reasons and some because there is a potential problem that needs further investigation About 10% of patients who receive routine mammograms get called back for another look. It's news that can hit hard emotionally and financially — but a new state law will require many insurers. When a patient is called back from an abnormal screening mammogram, additional imaging of the breast will be performed referred to as diagnostic imaging. This article is intended to serve as a general guide to diagnostic imaging. Every patient presents a unique case and the diagnostic workup may vary based on your individual situation as well as on the protocols set forth by the imaging. 1) DCIS - found on a mammogram. 2) IDC, .8 mm found when my surgeon felt a dimple on the underside of my breast and decided to remove what ever was causing the dimple. 3) IDC, 1.2 cm found via MRI. 4) 2.5 cm of DCIS found after bmx, noted in pathology report. So 25% of success rate for mammograms in my case

This is How I Survived My Mammogram Call Back by Rebecca

The call-back mammogram is referred to as a diagnostic mammogram. The radiologist will characterize the calcifications as: Clearly benign: no further testing is needed; Likely benign: you may be asked to come back in 6 months for another mammogram to check on any changes in the features of the calcification 3D mammogram call back Stories. Lots of women are called back for a second mammogram. But when I was told I needed additional testing - a diagnostic mammogram - I was terrified. You see, I had a 3D mammogram - also known as tomosynthesis or tomo, for short - and not by chance. I had heard about the new technology and decided to do a little. A call back to follow up on mammogram results usually means additional imaging. Usually what they want to do is to take a magnified view: a closer look at an area using a mammogram and possibly adding in an ultrasound, Mark says. An ultrasound will tell us additional information, like if that area is solid or if there's fluid in it

If You're Called Back After a Mammogra

Of course, the mammogram was a bit uncomfortable, and yes, the machine was cold. However, the procedure was quick, and each image took only about 10 seconds. The morning after my mammogram, the nurse practitioner called to tell me that the screening showed a suspicious area and asked that I come back as soon as possible Call Back Tips. I probably did everything one shouldn't do when getting call back. I panicked. I went to the worst-case scenario. Do not do what I did. Instead: Don't panic: I know it's easier said than done, obviously, but until you know for sure, try to keep a level head. Realize that around 10% of women receive call backs

The Dreaded Mammogram Callback - Tough Cookie Momm

Breast screening uses a breast x-ray, called a mammogram, to look for breast cancers that may be too small to see or feel. Breast cancer is the most common cancer in women in the UK. The sooner it's diagnosed, the more effective treatment is likely to be. Screening can pick up cancers earlier, before there are any signs or symptoms This is called a false positive. Besides worrying about being diagnosed with breast cancer, a false positive means more tests and follow-up visits, which can be stressful. In this study, the researchers compared mammogram results from 15,633 women who had a 3-D mammogram to results from 10,753 women who had a conventional 2-D digital mammogram

Now women from Hawaii to California, New Jersey to New York, are receiving letters about their breast density because of state legislation championed by Nancy Cappello, a 61-year-old Connecticut woman. Her breast cancer had spread to her lymph nodes by the time it was diagnosed 10 years ago, even though she had had normal mammograms every year A mammogram is an X-ray of your breasts that checks for signs of cancer. Breast screening mammograms aim to detect breast cancer early, before you or your doctor notices any signs of a problem. Your doctor may also refer you for a mammogram and other tests if you have possible signs of breast cancer. This is sometimes called a diagnostic mammogram But weeks went by. The order was waiting. That's when a Fairview scheduling agent took it upon herself to call Katie and schedule the mammogram in late December. I went from happy holidays to a mammogram screening, an ultrasound, and a biopsy, all within 24 hours, Katie recalls. Saying it was a whirlwind is an understatement. A screening mammogram usually take 1-3 days to get results. If there are old studies that need to be retrieved or ordered from elsewhere, it may take longer, sometimes even 2-3 weeks. There may be guidelines to limit the maximum to under 4 weeks. Diagnostic mammograms are usually interpreted in the same day, unless old films are needed

I panicked after I was called back for a mammogram — here

Combining a 3D mammogram with a standard mammogram can: Reduce the need for follow-up imaging. When doctors detect abnormalities on standard mammogram images, they may recommend additional imaging. Being called back for additional imaging can be stressful. It may take extra time and lead to additional costs A mammogram can help a doctor to diagnose breast cancer or monitor how it responds to treatment. Fatty breast tissue appears grey or black on images, while dense tissues such as glands are white A mammogram is an x-ray picture of the breast. Mammograms can be used to check for breast cancer in women who have no signs or symptoms of the disease. This type of mammogram is called a screening mammogram. Screening mammograms usually involve two or more x-ray pictures, or images, of each breast. The x-ray images often make it possible to. Accuracy of Mammograms. Mammography is good at finding breast cancer, especially in women ages 50 and older. Overall, the sensitivity of mammography is about 87 percent [ 31 ]. This means mammography correctly identifies about 87 percent of women who truly have breast cancer. Sensitivity is higher in women over 50 than in younger women [ 2 ]

I had to get a biopsy after a mammogram

Dense breast tissue refers to the appearance of breast tissue on a mammogram. It's a normal and common finding. Breast tissue is composed of milk glands, milk ducts and supportive tissue (dense breast tissue), and fatty tissue (nondense breast tissue). When viewed on a mammogram, women with dense breasts have more dense tissue than fatty tissue Mammography use. Percent of women aged 40 and over who had a mammogram within the past 2 years: 66.7% (2018) Source: Health, United States, 2019, table 33. pdf icon. [PDF - 9.8 MB Your breasts may be sore after the mammogram. The whole process should take about 15 minutes. After a screening mammogram, the technician will look at your X-rays to make sure they don't need to be retaken. Technicians don't examine the X-ray for signs of cancer — a doctor called a radiologist will do that after your appointment is over The mammogram is examined and the results sent to the woman and her GP, usually within two weeks. In about 96 out of every 100 women screened the mammogram will show no sign of cancer -- this is a normal result (NHS Breast Cancer Screening Programme - 'Helping you decide' leaflet July 2013)

At the University Hospitals Breast Health Center, our board-certified breast health specialists are dedicated to providing the best care possible through advanced digital mammograms and breast screening. Learn about diagnostic breast screening, tomosynthesis and digital mammograms available across Northeast Ohio today This can cause your mammogram to appear abnormal even when you are OK and there is no indication of cancer. But, enlarged lymph nodes can result in a false positive on your mammogram. You may get a request to return for further testing — a call-back — which can be unsettling. The COVID-19 Vaccine and Enlarged Lymph Node

A mammogram is an x-ray of breast tissue that can find changes too small to be felt during a physical examination. A screening mammogram is used to check for breast cancer in women who have no signs or symptoms. A diagnostic mammogram is used to check for breast cancer after a lump or other sign or symptom has been found A call-back is fairly common, especially when a woman has dense breast tissue. The new 3D technology does provide clearer images. It has reduced the number call-backs. Fewer than 1 in 10 women who are called back for extra tests will actually have a cancer. These extra tests are done downstairs in Brookwood's Women's Diagnostic Center You may be called back due to technical issues like motion, image quality, or a mole or skin lesion that was not marked. A benign finding of a cyst or lymph node may show up as a mass on a mammogram requiring an ultrasound for further evaluation. Perceived Asymmetry or a Mass. This is the most common reason for being called back I had my yearly mammogram 3 weeks ago and a few days later I got the call to come back for a diagnostic mammogram and a breast ultrasound. I didn't tell hubby or anyone except my friend who is a physician. I didn't want to worry anyone and 3 weeks was such a long time to wait

Mammo Whammo: Mammogram Anxiety and How to Manage It A few weeks back, an anxiety sister told me she was a bit more anxious than usual. When I asked her if she knew why (after all, sometimes we have no idea what causes our spinning), she responded that she had her yearly mammogram scheduled for the next day My mammogram missed my breast cancer. New Yorkers Irina Brooke, Jamie Vento, Alexea Gaffney and Rosanna Silber all got diagnosed with breast cancer shortly after their mammograms came back clear. By texting NHR to 844-539-1128, you are providing your electronic signature expressly consenting to be called and texted (including by prerecorded messages, using an autodialer, and/or automated means) with alerts, stories, reports, and marketing communications from Health Sense Media, LLC. and its authorized representatives at the phone number you provide, including landlines and wireless. Study finds 12-14 percent rate for mammogram patient callbacks increases cancer detection. Breast cancer detection increases significantly when radiologists recall mammogram patients for. MRI requires lying face down on a support in a relatively closed tunnel and injection of intravenous contrast. MRI will show cancers not seen on mammography in at least 10 of every 1000 women screened. Follow-up testing including biopsies for false positives occur in 6% to 12% of women. Invasive and in situ cancers are well seen on MRI and are.

Mammogram recall, anxiety

An Unexpected Phone Call. Less than two hours after my mammogram, the phone call came. They found something. In both breasts. The right side was the one that was more concerning. I had to go in for a magnified mammogram and ultrasound. I told a couple of close friends. They shared their own stories of being called back, trying to allay my fears Your Mammogram Call Back: Know the Facts. A mammogram is the most important imaging tool that doctors use to detect early signs of breast cancer. In fact, a mammogram can detect breast cancer up to three years before it is actually felt. It is a painless and quick screening test that could save your life

11. Reaction score. 3. Nov 3, 2020. #1. Health anxiety is the absolute pits, it consumes you . I went for my first mammogram yesterday, I am literally terrified I am going to get called back as they have found something abnoreal. I have gone through a bottle of rescue remedy in the last 2 days Like getting your first pap smear or having your first PMS breakdown in a public place, getting a mammogram is just one of those things women do because it's part of the business of being a woman Breast screening uses an X-ray test called a mammogram to check the breast for signs of cancer. If you are called back for more tests, you may have a breast examination, more mammograms and. A call that a mammogram has turned up a mass in your breast can test your faith and put the important things in life in a different perspective, says the Rev. Damaris Whittaker So You Got a Call Back. Now What? Back. October 25, 2019. Getting a call back is not as scary as you think! Check out this new infographic by Jefferson Radiology and learn how you can benefit from early detection. #EarlyDetectionSavesLives. YouTube. Recent Stories

Newsroom. Publications. Health Matters. Mammograms: Facts on 'False Positives'. About 67 percent of women age 40 and older get a screening mammogram every one or two years. Of those who get screened, 16 percent will get called back for further testing if it's their first mammogram, and 10 percent will be called after subsequent mammograms A type of surgery called a wire-guided biopsy, again under general anaesthetic, was carried out in May to establish exactly the nature of the cells. when a mammogram came back normal. I should. Why I Am Not Having A Screening Mammogram. Conventional Canadian wisdom suggests that all women should have a screening mammogram starting at age 50 (age 40 in most of the USA). The reason given is that mammograms detect cancers earlier, while it is still possible to treat them. Instead of dying of cancer, you can be a survivor If you have questions about your breast density, we encourage you to talk with your healthcare provider and consider having a 3D screening mammogram. Wake Radiology is the Triangle leader in 3D mammography with 10 units in multiple offices throughout the Triangle. You can schedule a mammogram appointment by calling 919-232-4700 or by requesting. Spiculated focal mass. Up to 80% (but not 100%) of these masses are cancerous. A biopsy of these is essential. If you see this on a report, you have reason to be concerned, but be glad you had the.

Follow Up Mammogram: An Unexpected and Scary Call Bac

Last Wednesday, I had my annual exam, along with a mammogram. I received a call on Friday that I need to come in because they wanted to re-check my mammogram. It's scheduled for tomorrow morning, and Im freaking out! I've heard that about 10% of women are called back for a re-check, and of those 10%, 85% are fine, but I'm still freaking out 5. Stay ahead of scheduling. On your way out, book for next year to ensure that you actually get annual screening mammography.. 6. With annual screening mammograms, don't let concerns about radiation dissuade you. A mammogram is an extremely low dose X-ray, and the risk of the minimal radiation exposure is far outweighed by the.

Mammogram Call Back - Redhead Can Decorat

Hi, I got the results of Mammogram yesterday which has always come back normal but it has been 3 years this time. I am 59, never had children. Results came back as New regional Microcalcifications at right upper quadrant and subcentimeter nodular asymmetry posterior and superior right breast Six months after her clear mammogram result, she was diagnosed with breast cancer. After going through breast cancer surgery , 16 rounds of chemo, 6 weeks of radiation, and hormone therapy, Kaufield knows firsthand how cancer can ravage you, and is so thankful she caught it when she did In fact, mammography only reduces the relative risk of dying by about 20% overall, and by just 15% for women in their 40s, Dr. Keating explains. If we screen 10,000 women in their 40s every year for 10 years, we'll find about 190 to 200 cases of breast cancer. About 30 women will die of breast cancer regardless of the mammogram, and about. We only call back patients that we really need some additional information on. So what happens is the patient gets the call, We want you to come back. Usually, we want you to come back for some additional mammogram views, and that's because a lot of the times when we're calling you back, it's because we're compressing a three-dimensional.

Why is compression necessary during a mammogram? Compression helps to spread out the normal fibroglandular (dense) tissue of the breast making it easier for radiologists to see through the breast tissue and detect abnormalities that might be hidden by the overlying tissue. If the breast is not well compressed, overlapping tissue can look like a. Getting called back after a mammogram doesn't necessarily mean you have cancer. It does mean something needs clarification. Sometimes, a mammogram will have a BI-RADS score of 0 A mammogram is a non-invasive X-ray used to check breasts for breast cancer and other abnormalities. It is the only test shown to reduce breast cancer deaths. Mammograms can detect cancer early — when most treatable — long before it can be felt. This improves odds of survival and can help avoid more extensive treatment

Too often, I see women who noticed a lump in their breast and immediately got a mammogram or a CT scan, but no one considered whether they should get a bone scan until much later. Call 202-877-XRAY to schedule your regular mammogram and stay on top of your breast cancer risk A diagnostic mammogram, as a rule, is only ordered when the doctor needs to take a closer look at a specific part of your breast tissue. It's part of any successful breast cancer risk assessment program, designed to catch problems before they can have a serious impact on your overall health. To be clear: most diagnostic mammograms turn out to. A mammogram is an x-ray of the breast. While screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms, diagnostic mammograms are used after suspicious results on a screening mammogram or after some signs of breast cancer alert the physician to check the tissue.. Such signs may include: A lump; Breast pai If CAD marks an area on the image, the radiologist goes back to the original mammogram to review the area in detail to determine if further evaluation is necessary. Breast Ultrasound A breast ultrasound is not a screening tool, but may be used to further evaluate an abnormality felt during a physical breast exam or seen on a mammogram Here's my take on my own breast biopsies, with the important caveat that everybody's experience is different — because of differing personalities, way to cope with stress, type of biopsy, health care environment and health care professionals. This is a personal insight into the way I felt last year this time

Breast asymmetry is very common and affects more than half of all women. There are a number of reasons why a woman's breasts can change in size or volume, including trauma, puberty, and hormonal. For every 1,000 women who have a screening mammogram, about 100 are called back for a diagnostic one, said Dr. Avice O'Connell, director of UR Medicine's Women's Imaging. She said maybe 1. Schedule Your Mammogram. To schedule your mammogram, call Bronson Central Scheduling at (269) 341-8700 or (888) 741-6415. Mammograms Save Lives. Prevention and early detection are the best ways to fight breast cancer. Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health 1 Annual Screening. 2 Eastside Locations. 3-Dimensional Images. Don't delay your annual mammogram. The Overlake Breast Health Center offers the highest level of safety, comfort, clarity and convenience. To schedule your mammogram, call (425) 688-5985. Read more here: https://bit.ly/3xNFLu3 For more information or to schedule a 3D mammogram, call (770) 736-2551. At Eastside we are dedicated to finding breast cancer at its earliest stage. 3D Mammography is a proven screening exam that results in 40% improvement in cancer detection while decreasing patient call backs. Ask your doctor about this test or schedule a 3D mammogram online

Called back after mammogram - but do not want to google

7 reviews of Kaiser Mammography This is the only place I have gone for mammograms. I knew and trusted the radiologist who read the mammogram films and this is where I started having them when I reached that age. Though he retired several years ago, I still come to Martinez for my yearly mammograms. It's where my records are and it isn't that much farther than Kaiser Richmond, where I get most. Treatment of these cancers is called overtreatment. Overtreatment can include treatments recommended for breast cancer, such as surgery or radiation therapy. These can cause unnecessary and unwanted side effects. Other potential harms from breast cancer screening include pain during the procedure and radiation exposure from the mammogram test.

Called back after abnormal 3D mammogram - DC Urban Mo

A mammogram is a specific type of breast exam used to aid in the early detection and diagnosis of breast diseases in women. Mammograms are X-rays of breast tissue. They are used for early detection of breast cancer and diagnosis of other breast conditions. They can detect a cancerous lump when it is the size of a pinhead, about two years before. If 3D mammography is not covered but you would like to have it, the out-of-pocket fee is $75. If you do not have insurance, please speak to a Gundersen financial counselor to find out what your out-of-pocket cost will be. To schedule a 3D mammogram, call your preferred location or use MyChart (available at most locations) The exam is very similar to the conventional mammogram. During a mammogram, a female imaging technologist will position your breasts on the imaging equipment. To get a high-quality picture, the breast must be compressed. The mammogram compresses the breast for a few seconds while an image is taken. The entire procedure takes about 15 minutes

What is your mammogram story? I just got a call back and

That mammogram in my late 40s had detected a warning sign: a tiny cluster of calcification in my left breast. I needed a stereotactic core needle biopsy, a procedure where the suspect spot is located via mammogram, extracted with a special needle, and sent to a pathology lab to see if the tissue is normal or not