What's
This About Mammograms?
Breast
Cancer Screening Benefits Debated
An estimated
175,000 new cases of breast cancer are expected to be diagnosed among
women in the United States during 2003.
After
fighting for years to get women to go through a procedure that can be
both uncomfortable and embarrassing, the message is finally getting through.
Regular
mammograms DO improve survival.
The
earlier breast cancer is diagnosed, the better the chances are for survival.
An article in the British journal The
Lancet reported that mammograms do not improve the survival rate
for Breast Cancer.
I
first saw the article on the Internet, then watched in horror as all of
the local TV news shows picked up the story. Is it possible that
one article may destroy years of education and immense gains in lives?
The
Lancet article reviewed eight studies. The six that found mammograms
lowered breast cancer death rates were deemed to be flawed. The
two that showed no gains in survival were well designed.
If
this is a call for better design of scientific studies, there is no argument.
If it causes women to put off getting a mammogram, it is dangerous.
Not
A Perfect Tool
There are cases where mammography is not the ideal tool for diagnosis
of breast cancer.
- Mammograms
are known
to miss a significant number of breast cancers, especially in younger
women.
- Approximately
5-15 percent of breast cancers are not detected on mammograms
- Often
cancers are only revealed at more clinically advanced stages.
- False
positives can occur.
- Of the
women who follow up with biopsies of an abnormality, about 70 percent
do not have cancer.
- Magnetic
Resonance Imaging (MRI) has been shown to be effective in detecting
and staging invasive lobular breast cancer, a form of breast cancer
that historically has been difficult to diagnose accurately by mammography
or ultrasound.
Clearly,
mammography is a tool that can be improved and superior training of technicians
who are responsible for interpreting the findings is vital.
Do these
findings mean that mammograms are useless?
Absolutely not.
The American
Cancer Society and the Susan G. Komen
Foundation's response to The Lancet article gives solid facts
to show the results of increased use of mammograms by women in the United
States.
Harmon J.
Eyre, MD, chief medical officer for the American Cancer Society (ACS)
states that, "In the early 1980s, when only 13 percent of American women
were getting mammograms, the average size of breast tumors at diagnosis
was 3.2 centimeters (about 1 1/4 inch). By the late 1990s, 60 percent
of women in the US were having regular mammograms and the average tumor
size had dropped to 2 centimeters. Also, in most cases diagnosed today,
the cancer has not spread to the underarm lymph nodes; decades earlier
this was not the case."
In England,
1995 figures showed death rates from breast cancer had fallen by 13% among
women aged 50-64 since their mammogram breast screening
program was introduced in 1988.
The Real
Results of This Report
After the article in The Lancet appeared, many breast screening
centers reported a drop in appointments for mammograms.
The established
breast cancer research and medical communities in the United States and
Great Britain have come out resoundingly in favor of the benefits of regular
mammograms.
Hopefully,
the community of potential breast cancer victims will listen. The odds
of catching a malignancy in the earliest, most treatable stages without
regular mammograms are not good enough to bet your life on.
January
10, 2000
Last
updated March 30, 2006
also
see featured How To -> How
to Prepare for a Mammogram
Elsewhere
on the Web:
Screening
Mammograms: Questions and Answers
Mammograms
and Other Breast Imaging Procedures
Breast
Cancer Screening Trial Shows Digital Mammogram Benefits
