Another Study Asks If Mammograms Are Helpful or Harmful

In yesterday’s New York Times, there was an article, “Vast Study Casts Doubts on Value of Mammograms.” The writer explains how the study questions whether mammograms save lives or impose unneeded tests and treatment. You can imagine how upsetting this uncertainty is, especially for a breast cancer survivor.

In all cancers, there is a long-standing debate about how worthwhile scans are versus the radiation imposed on the body from these tests and the anxiety induced from such tests versus leaving a tumor in place that wouldn’t harm or kill someone. I understand the arguments on all sides, but I always have a strong reaction when someone says mammograms aren’t worth it.

For me, if one life was saved from an annual mammogram, then it’s worth doing. Especially if that one life is mine or someone I love.

I was diagnosed with breast cancer at the age of 39. I hadn’t yet had a mammogram. Even though I come from a long line of women with breast cancer, none of my doctors suggested I get a mammogram before turning 40. And a few years earlier, a national government panel recommended mammograms be done starting at 50, instead of 40. Even more reason for my doctors to not push for a mammogram.

I often kick myself about not insisting that I get an annual mammogram starting at 35 years old, because of my family history. I found my lump in a routine self-exam, which I did without fail every month since I was in college. If I did get annual mammograms before age 40, would we have found my breast cancer earlier? Would we have found it before it spread to my lymph nodes? Would it have spared me having a mastectomy? Would I not have had to go through chemo and radiation? Of course we don’t know and will never know the answers to these questions. What ifs do little but create guilt. So I try to let that go. But I do admit it creeps into my mind sometimes.

Dr. Susan Love, one of the smartest, most well-known and accomplished surgeons and advocates on breast cancer, was interviewed about this study on KRCW’s Press Play with Madeleine Brand. Dr. Love talks about how there have long been questions about mammograms. And how this study shows that there are many different types of breast cancers and there isn’t a one size fits all approach to breast cancer screening and treatment. Which means we need research and studies to continue.

As Dr. Carol Lee of Memorial Sloan Kettering Cancer Center explains on the PBS NewsHour, this study is an update on a study reported nearly 20 years ago. Her opinion is that this study is just one in a long list of studies about mammograms that actually show a benefit of mammograms. Her opinion is that mammograms do save lives. I tend to agree with her.

I have another problem with this study, which was done with women ages 40-59. Once again, when breast cancer is researched, talked and written about, young women (women 40 and under) and women of color are barely, if at all, discussed.

As the Young Survival Coalition states, it is estimated that more than 250,000 women diagnosed with breast cancer at 40 or younger are living in the U.S. today. More than 13,000 young women will be diagnosed this year.

Mortality rates for breast cancer have been decreasing since 1989, with larger decreases in women under 50. That’s great new. But what about women under 40? The survival rates for young women are not good. Compared to older women, young women generally face more aggressive cancers and lower survival rates. The statistics on women of color aren’t good either. Although the overall lifetime risk of breast cancer is lower for Black women compared with white women, the death rates are higher.

Would annual mammograms save the lives of more young women and women of color?

When we look at the benefits and disadvantages of mammograms, let’s expand the conversation. Let’s look at all types of breast cancers, all ages of women and all ethnicities. Not until there’s a cure for breast cancer or a vaccine, the goal continues to be to save lives. And in my opinion, annual mammograms play a part in that.

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2 thoughts on “Another Study Asks If Mammograms Are Helpful or Harmful

  1. Dear Stacey, I came across your blog via “Jouneying beyond breast cancer”, and I was taken in by your latest post on your oophorectomy and still being asked about your last period (this happens to me, too). We have a few parallels in our stories, and this makes me feel that I can answer some of your questions (even though I suppose you posed them rhetorically) in this post. I had a BRCA1/2 gene test back in 2002, and I tested positive for both genes (long history of breast and ovarian cancer in my family). As a result I had an annual mammogram, and there was talk of a prophylactic bilateral mastectomy at some point in my future. I was 28 then and having a baby or two (and being able to breast feed them) was definitely still on my agenda for life. In 2008 my gynaecologist attended a conference where she learnt that MRIs yield better results when it comes to early detection. so with a series of letters including second opinions she managed to persuade my health insurance to cover one MRI per year for me. In addition I had ultrasounds and blood tests every six months.
    In January 2014 the annual MRI showed up a small lump in my right breast. Following a biopsy it turned out that it was stage 1 triple negative breast cancer. I hasn’t felt the lump but once I knew where it was I could feel it. Suddenly there were myriad meetings with various doctors; two breast surgeons, a plastic surgeon, the radiologist, an oncologist etc, and in the middle of all that meeting frenzy my MRI pictures were lost (they were found again later, I’d left them behind some chairs in one of the doctors’ waiting rooms), so they decided to do a mammogram to have another set of pictures. Well, guess what.. there was nothing to see on the mammogram pictures, it was totally clear.
    I’m not saying that mammograms are useless, they are better than no scans at all if you want to catch this disease as early as possible, but I think I would have easily been a stage 2 with affected lymph nodes had I relied on mammograms. So my answer to your question is that despite all my regular scanning, despite knowing that with my corrupted genes there would be an 86% chance of breast cancer in my future, at 39 the diagnosis still came as a shock, and I still had to have a bilateral mastectomy and six cycles of very aggressive chemo.
    My ovaries and tubes were removed in November 2014 (I’d turned 40 by then), and I’m now dealing with the hot flushes, night wakings, headaches etc, but it’s all small potatoes compared with chemo. That’s one place I don’t want to return to!
    I had my first MRI last week, and I’m hoping for an all clear – despite the radiologist and me feeling a little lump right next to the implant. Fingers crossed!
    Wishing you well and hope that the nurses at your breast centre won’t ask you about your last period again….
    Kats

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