Shedding Light When Others Cast Doubt on Mammograms

NY Times has recently reported on “one of the largest and most meticulous studies of mammography ever done” (the study was published in The British Medical Journal), saying that 90,000 women over a quarter-century were studied, and those studies led to doubts.

Doubts about mammography scans? What?

“It found that death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not.” A small chart on the side of the article shows that women who had mammograms and women who had physical exams had similar statistics.

“Researchers sought to determine whether there was any advantage to finding breast cancers when they were too small to feel. The answer is no, the researchers report.”

Wait, so it is possible to have a cancerous lump too small to feel? And a mammography can still detect it?

Yes, which is why it seems that these “findings will not lead to any immediate change in guidelines for mammography, and many advocates and experts will almost certainly dispute the idea that mammograms are on balance useless, or even harmful.”

Dr. Richard C. Wender, who is the American Cancer Society’s chief cancer control says, “[Mammography] reduces the death rates from breast cancer by at least 15 percent for women in their 40s and by at least 20 percent for older women.”

So where could the doubt come from?

The study suggests that mammograms don’t save more lives, but they do increase false positives, leading to unnecessary fear and treatment. However, some of the support is flawed:

  • The study did not randomly assign women to be screened.
  • They suggest that early detection is less important thanks to drugs like Tamoxifen.
  • They assume people truly understand the disease.
  • Ignorance is bliss?

The article says, “It might be possible that mammography screening would work if you don’t have any awareness of the disease,” but do we really? Yes, we see pink ribbons flooding our products and commercials, and we all know what October means, but does anyone really understand this disease? If you felt a lump in your breast, would you know the difference between cancer and a small sack of dense, fatty tissue?

“Many cancers, researchers now recognize, grow slowly, or not at all, and do not require treatment. Some cancers even shrink or disappear on their own. But once cancer is detected, it is important to know if it is dangerous, so doctors treat them all.” I, personally, wouldn’t want to wait to see if my cancer went away on its own. I wouldn’t want my doctor to wrongly assume that it wouldn’t grow, and then it did. I would want to know and get it taken care of. Wouldn’t you?