Mammography: The Debate Continues
Our goal is for you to live a long and healthy life, and more specifically to live a life unaffected by breast cancer. Breast cancer is a fickle foe, and there is still much to learn about finding and treating breast cancer in the most accurate, appropriate way with the least harm. We stand by our recommendation for screening mammograms annually, starting at age 40 because we are convinced early detection saves lives!
Did you know that when caught early, breast cancer can have a survival rate over 90%? The survival rate falls for patients dealing with advanced stage breast cancers, so our goal is to catch cancer at its earliest, most treatable stage whenever possible! Mammograms are currently the best tool we have for early detection, although not a perfect tool. Breast cancers can be missed by mammography, especially but not only in patients with dense breasts. This is why we advocate monthly self-exams for breast self-awareness and clinical breast exams as additional means of screening for abnormalities. In patients with higher than average risk, supplementing screening with additional imaging with breast MRI or breast ultrasound may be appropriate. This multi-pronged approach is the best way we have to detect breast cancer early.
The debates about mammography rage on. The US Preventative Services Task Force recommendations in 2009 were at the start of a flurry of controversy over the benefits and harms of mammography. The Task Force recommendations have been challenged by experts, including members of the American Cancer Society, and the American College of Radiology amongst many others. The harms of mammography identified by the Task Force and further discussed in subsequent reports have primarily focused on biopsies prompted by mammography done for non-cancerous conditions (the false-positive mammography calls) and patient anxiety. We do not want to underplay anxiety – we recognize it as a very real part of what we do in breast imaging. Undergoing a biopsy that turns out to be for a benign finding is not ideal – but in our opinion, as well as those of multiple others, is worth it. Not going through a short, easily recovered out-patient procedure that may find an early breast cancer does not make sense to us.
With this debate recently again making the news, we want to be very clear: mammography is not perfect, but is the best approach we have for both saving lives from breast cancer and finding breast cancer at early stages when it is most treatable. Mammography is NOT perfect – we recognize that and advocate an approach that includes breast self-awareness and clinical breast exams by qualified providers. We applaud those who are researching for better ways of finding breast cancer and further defining those breast cancers most likely to be deadly.
Know your risk. Know you can take positive action. And know as much as you can about breast health (read all about it here!). We stand with the Society for Breast Imaging in their response to the recent JAMA assessment. Please take the time to read their statement, here.
The power is in your hands to put yourself on the road to your best possible health!
Originally published 4/4/14 on mammographykc.com.
