“Mammography saves lives.”
“Wait, mammography doesn’t save so many lives.”
“You should get screened annually from age 40 on.”
“No. Screening should be a part of your routine every two years, from ages 50 to75.”
Talk about confusing information. What’s a woman to think?
As a breast imager for the last 20 years, as a 50-something woman who is at risk of breast cancer herself, and as a daughter of a wonderful mom who succumbed to breast cancer at age 52, I am here to try and help you sort through the confounding, often mixed messages about mammography and breast cancer screening.
The impact of mammography on breast cancer mortality has been studied more than any other medical intervention. There is overwhelming proof that mammography has had a tremendous influence on breast cancer mortality. Yet, every few years over the span of my career, studies have attempted to prove it is not worthwhile.
Here are the facts: Mammography saves lives. No, it is not perfect. Mammography does not find all cancers, and in particular, has greater difficulty detecting cancers in women with dense breasts. Detecting disease before it causes symptoms in a population at relatively low risk of disease involves selecting women whose mammograms show they might have the disease. Most of them don’t.
For every 1,000 women who have a screening mammogram:
- 100 are recalled to get more mammography or ultrasound images
- 20 are recommended for a needle biopsy
- 5 are diagnosed with breast cancer
These 95 out of the original 1,000 women screened are called “false positives”, as they do not have breast cancer.
Is it stressful to be called back? Yes. Is it a relief to be told everything is normal? Yes. Does the biopsy hurt? A little bit, but not nearly as much as some dental work. Is it worth it to diagnose a cancer earlier than when a lump is present? Yes, absolutely. Studies show that death from breast cancer has dropped 30 percent since we started screening most women.
What you can do:
- Have an annual mammogram beginning at age 40 and continue to do so as long as you remain in good health.
- Have a conversation with your physician regarding the pros and cons of mammography. All women are at risk for breast cancer, even those with no family history. If we screened only those women with a positive family history, we would miss detecting 75 percent of breast cancers!
- Find out from your health care provider whether you are at increased risk, based on family history or other factors. If so, you may need additional screening – possibly including an MRI in addition to mammography. If that’s the case, you may also wish to consider genetic testing and counseling.
For more information about the value of mammography, please visit the following links:
It’s October. It’s breast cancer awareness month. But for the Fletcher Allen staff and physicians in the Breast Imaging Division, breast cancer awareness goes on all year long. I would love to answer your questions regarding mammography and breast cancer screening. We’re all here to help.
Sally Herschorn, MD, is Director of the Breast Imaging Division at Fletcher Allen Health Care