Mammography benefits questioned
Mammograms remain a viable way to detect breast cancer in the body, but others say that MRIs and other imaging are more effective, albeit more expensive. (October 15, 2012)
Roughly 15 years ago, mammograms were only recommended for women age 50 and older and then only every 3 years. However, new findings and higher incidences of breast cancer in women in their 40s has prompted the switch in screening recommendations. Is the switch safe and adviseable? Some professionals say no.
Mammograms remain a viable way to detect breast cancer in the body, but others say that MRIs and other imaging are more effective, albeit more expensive. A 2004 Canadian study reported in the Journal of the American Medical Association concluded that MRIs were more sensitive and more specific in detecting small breast cancers than mammograms, ultrasounds or clinical breast exams. The study found that screening by MRI detected 79.5 percent of invasive breast cancer, compared to only 33.3 percent by mammography.
Some also argue that the radiation present during mammograms may contribute to gene mutations that can contribute to cancer itself.
In 1992, a Canadian National Breast Screening Study found that women in their 40s are actually more likely to die of breast cancer after they receive a decade of annual mammograms than women who do not start getting mammograms until after age 50.
The American College of Physicians, which represents 120,000 internists, issued new guidelines in 2007 that urge women in their 40s to consult with their doctors about whether to have a mammogram, saying the benefits for younger women are less clear. Screening also carries the risk of radiation exposure, unnecessary biopsies, surgery, and maybe chemotherapy.
Furthermore, large population studies in Denmark and Canada have revealed that the death rates from breast cancer in women taking regular mammograms and women who have never had mammograms are identical. This could be because mammograms in themselves can be dangerous or because sometimes mammograms do not detect all cancers and can leave a woman with a false sense of security that she is cancer-free.
Women should not take their decision to get a mammogram lightly. Mammograms are often seen as preventative care, but it is important to realize that radiation is at play in mammogram imaging and to recognize the potential risks. A woman in her 40s may want to talk with a doctor about other screening options, including being more vigilant with self-examinations.