The Mammogram Question
Can mammograms reduce your risk of breast cancer or not? Should you have them or not? And if so, at what age should you start?
For years, researchers have debated whether mammograms save lives. Recent confusion over the effectiveness of mammograms started in October of 2001. Danish researchers published an article in the Lancet saying there were flaws in previous studies that showed mammograms to be effective.
The Problem: False Positives
When experts bring up the risks of mammograms, they're basically talking about the disadvantages of false positives. An example of a false positive would be a result showing there may be a tumor. A woman who has this type of result would have to undergo a breast biopsy, an invasive procedure, only to find that the tumor is cancer free.
The United States Preventive Services Task Force, an independent 15-member committee of experts that advises the Department of Health and Human Services, studied the mammography research and provided the government with its own recommendations.
The task force found that most abnormal mammograms, about 80 to 90 percent, are false positives.
On the other hand, the task force also found that women who received mammograms every 12 to 33 months were 23 percent less likely to die from breast cancer than those who did not have mammograms.
Newest Federal Guidelines:
Have Mammograms, and Have them Earlier
In 1989 and 1996, that same task force published two other breast cancer screening recommendations. At that time, they encouraged women to have mammograms between the ages of 50 to 69. But the group is finding evidence from newer studies that younger women also benefit. It now recommends that women begin having mammograms at age 40.
In a speech on February 22nd, the secretary of the Department of Health and Human Services, Tommy Thompson stated, "The best information we give women today, with the support of a new independent review, is to avail yourself of routine mammography if you're 40 or older. It's an important tool as part of a comprehensive effort to help save lives from the ravages of breast cancer."
The National Cancer Institute has acknowledged a need to improve methods of diagnosis and treatment of breast cancer, but they too support mammography as a way to detect breast cancer early.
For most women, it doesn't matter that they might have to undergo a biopsy for a tumor that isn't cancer. It doesn't matter that 80 to 90 percent of abnormal results are false positives. What matters to most women is that mammography does detect some cancers early, and the earlier cancer is detected, the higher the survival rate. Most women will say that having a surgical biopsy only to find out there was nothing seriously wrong is a small price to pay.
Some organizations, such as the Breast Cancer Resource Committee for African American Women, recommend that African-American women begin having mammograms at age 35. Talk with your doctor about when you should begin being screened for breast cancer.
The Lancet October 2001; The New York Times, 22 February 2002; American Medical News, 11 march 2002.