The Mammogram Debate
The screening mammogram has been a staple of preventive care for women for more than 3 decades. In recent years there have been questions as to the benefits of these mammograms and whether they actually prevent breast cancer deaths. Some clinical studies suggest that mammography does not save lives, while others show evidence that the survival rate goes up when cancers are caught early.
The primary arguments against screening mammography state that there is no measurable benefit and the possible detriment of over treatment and over diagnosis.1,2 Estimates of over diagnosis are said to range from zero to 30%, further fueling the debate.3
On the other side of the discussion, studies do indicate that detecting breast cancer in the early stages increases a woman’s chance for survival. One large study found that approximately 90% of women diagnosed with stage I or stage II breast cancer between 1990 and 2004 lived at least 5 years beyond their diagnosis.4 It is said that improvements in treatment since then make the survival rate even higher. A Swedish study published in 2011 indicated that screenings reduced breast cancer deaths by 30%.5 Dutch researchers likewise found that diagnosis of breast cancer at an early tumor stage remains vital.6
Should Women Have Regular Screening Mammograms?
The scientific divide leaves women wondering what to do. Should they have annual screening mammograms; or have them every other year or have no screening mammograms at all? Do the benefits of early detection outweigh the possibility of over diagnosis or over treatment? What makes the most sense?
Obviously, every woman is different. Family history, personal medical history, diet, exercise, smoking and alcohol habits all play into the risk factors for breast cancer and other cancers. There is no doubt that screening mammograms for women between the ages of 40 and 49 can be lifesaving. The American Cancer Society recommends that those at average risk for breast cancer should begin having annual mammograms at age 45 and begin biennial (every other year) screenings by age 55.
At SottoPelle®, we encourage women to monitor important aspects of their health on a regular basis. That includes regular cancer screenings along with physical checkups and lab tests. The bottom line is that you and your primary care physician should weigh all of the factors and health risks together and devise a sensible plan for cancer screenings—including mammograms—and other preventive care measures. After all, your good health and well-being are priceless and worth investing in.
“It is health that is real wealth and not pieces of gold and silver.”
1Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ 2014; 348 http://www.bmj.com/content/348/bmj.g366
2 Charles Harding, AB1; Francesco Pompei, PhD2; Dmitriy Burmistrov, PhD2; H. Gilbert Welch, MD, MPH3; Rediet Abebe, MASt4; Richard Wilson, DPhil2Breast Cancer Screening, Incidence, and Mortality Across US Counties. JAMA Intern Med. 2015;175(9):1483-1489.
3 Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367:1998-2005. http://www.nejm.org/doi/full/10.1056/NEJMoa1206809#t=article
4 Hwang ES, Lichtensztajn DY, Gomez SL, Fowble B, Clarke CA. Survival after lumpectomy and mastectomy for early stage invasive breast cancer: the effect of age and hormone receptor status. Cancer. 119(7):1402-11, 2013.
5 Tabár L, Vitak B, Chen TH, et al. Swedish Two-County Trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology. 2011;260:658-663.
6 Saadatmand S, Bretveld R, Siesling S, Tilanus-Linthorst M. Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173,797 patients. BMJ 2015; 351:h4901.