“Mammogram’s Role as Savior is Tested,” an article published in today’s New York Times health section, questions whether our reliance on mammograms as an early detection tool translates to saving lives. Researchers’ answers? Not for the majority of women. So, should we stop having regular screening mammograms? Or is there still value in this long-accepted part of our over-40 health protocol?
Examine your breasts regularly. Get a yearly mammogram. Report any lumps or other breast changes to your doctor immediately.
This is the mantra most of us over age 40 have long embraced, as we seek to protect ourselves from breast cancer. Sounds like a sensible plan, doesn’t it?
Well, yes… and no.
Back in November, 2009 theUnited States Preventive Services Task Force (USPSTF) released new guidelines recommending women begin screening mammograms for breast cancer no earlier than age 50, and that those tests be given not every year, but every other year.
A firestorm of criticism from women, breast cancer advocacy groups, and even physicians resulted in the government’s department of Health and Human Services (HHS), which had requested the new guidelines, to quickly back off those strict recommendations.
When the dust had settled, HHS’s stance was that women without any known risk factors for breast cancer should discuss screening with their physician starting at age 40; and each woman should make her own decision about screening, regardless of the USPSTF’s recommendations.
Now (perhaps in recognition of Breast Cancer Awareness Month?), mammograms are back in the national media. A piece published online Monday in The Archives of Internal Medicine – Likelihood That a Woman With Screen-Detected Breast Cancer Has Had Her "Life Saved" by That Screening – flames the coals again, threatening to derail the “early detection saves lives” work the American Cancer Society (ACS) and other major cancer organizations have been doing for decades.
And you know what? Maybe it IS time for a change.
After all, a couple of years ago the ACS backed off its recommendation for monthly breast self-exams, after it was shown that women who performed the monthly exams were no less likely to die of breast cancer than women who did. Now, the ACS recommends simply “knowing your breasts,” so that you’ll notice if there’s a change.
And, if you do notice a change? With so many different causes for breast lumps, most premenopausal women are now advised to hold off on reporting lumps to their doctor, to see if they disappear during the course of the menstrual cycle.
So the whole early detection process has evolved, undergoing subtle but significant changes. Why not include mammograms as well?
Dr. Gilbert Welch, co-author of the new study, is a longtime advocate of evidence-based health care – basically, the use of data and statistics, rather than emotion, to steer medical decisions. His study concludes that on average, about 3% to 13% of women diagnosed with breast cancer, across all age groups, actually have their lives saved by a screening mammogram.
