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To Mammogram or Not To Mammogram, That is the Question

To Mammogram or Not To Mammogram, That is the Question

Breast Cancer in the News
A new study indicates that breast cancer screening has not been a big factor in reducing breast cancer deaths. But there’s more to the story, according to the American Cancer Society (ACS).

Published in the British Medical Journal (BMJ), the new research concluded that in countries where breast cancer screening has been implemented, it has not had a direct part in reducing the number of deaths, and attributed the lower mortality rate to better treatment.

Otis Brawley, M.D., chief medical officer of the ACS, released a statement that said, in part:

“First, the study does not measure how many women were actually screened.

“Second, just because two countries seem to share similar geography, doesnít mean that their breast cancer mortality trends are easily compared. For example, Sweden had about 10 percent greater breast cancer incidence than Norway during the study period. Higher incidence would clearly influence mortality rates over time. Also, while Sweden began introducing screening in 1986, not all counties introduced it in that year, and of course, not all women received a mammogram in 1986. It takes time to invite the population to screening, and full implementation didnít occur until 1992-1993.

“Third, and most important, many of the deaths attributable to breast cancer during the time period were diagnosed long before screening was introduced. In other words, there was not enough time to measure a population-wide effect in this study.

“Finally, we donít know how effectively mammography is functioning in the countries in these comparisons. The effectiveness of mammography on a population-wide basis will be influenced by how many women get screened and the accuracy of the screening.”

Dr. Brawley believes that a combination of better treatment and heightened awareness of breast symptoms have resulted in earlier treatment and a reduction in breast cancer deaths.

“The American Cancer Society continues to advise women age forty and older to get a high quality mammogram and clinical breast examination on a regular basis. [...] Women should know how their breasts normally look and feel, be alert for changes, and when there are changes, seek expert help. Mammography is not perfect. It will not detect all breast cancers, and not all women are at an age when mammography is recommended. Thatís why a heightened sense of awareness is an important complement to regular mammography screening.”

I am among those women who discovered their own breast lump. It happened to be during Breast Cancer Awareness Month, and 13 months since my previous mammogram. What does all that mean? I don’t know. What I do know is that some breast cancers, like mine, are very fast growing and aggressive. Early treatment is crucial.

If I had been less self-aware, my upcoming mammogram may, indeed, have been how my cancer was found. How aware are you of your own breasts? Will you continue to get regular mammograms? Please take a moment to answer the poll below.

Sources: BMJ; American Cancer Society

Living with Triple-Negative Breast Cancer Series
#1 The Lump in my Breast: Meeting the Enemy
#2 Most Breast Lumps are Non-Cancerous: Would mine be?
#3 The Mammogram, the Ultrasound, and Ďthe Lookí
#4 The Biopsy and Breast Cancer Confirmation
#5 A New Twist: Itís Triple-Negative Breast Cancer
#6 Before the Mastectomy: Planning for the Future
#7 Mastectomy Day: What itís like to lose a breast
#8 After the Mastectomy: Unveiling and Staging
#9 10 Odd Things to Say to Someone with Breast Cancer
#10 Cancer Battle Plan Phase 2: Chemotherapy
#11 5 Things I Love About my Very Expensive Health Insurance
#12 10 Simple Gestures of Kindness with Healing Power
#13 Half a Year on Chemotherapy and Taking Nothing for Granted
#14 Breast Cancer Treatment: Weighing Reward and Risk
#15 The Radiation Decision, The Long Road, The Badge of Honor
#16 The Healing Power of Nurses
#17 Grieving Son Recounts Mom’s Battle with Triple-Negative Breast Cancer

Access all posts in the Living with Triple-Negative Breast Cancer Series

Follow on Twitter @AnnPietrangelo

Image: istockphoto.com

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55 comments

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7:53AM PST on Dec 10, 2013

All this talk about insurance companies and what they will and won't allow and what their ulterior motives are...begs this question. Who put them in charge anyway and when? Why doesn't the AMA throw the thieves out? They wouldn't exist without the doctor's compliance. How is it that they are the ones deriving the biggest financial gains in this industry? Why would anyone want to become a doctor in this day and age when their income is based on the number of procedures and tests they order in the shortest span of time whether it's needed or not. Patients can't trust their doctors to give them an unbiased opinion any more. One needs to become one's own health advocate. The system is corrupted.

5:52AM PST on Dec 10, 2013

A mammogram saved my sister's life, it was just caught in time, nothing else to say.

4:15PM PDT on Jul 24, 2013

Just to let people know.I have been pushed to have a mammogram for 10+ years. There are reasons and yes it runs in my family. I never had one yet and I'm late 40's. I'm sure it will backfire. I have everything else.

If a woman does not want to have one,then don't. BUT it is a necessary test and should always be covered and done if someone wants one.

4:11PM PDT on Jul 24, 2013

YES!! No question. Always.

4:00PM PDT on Jun 19, 2013

to each their own

7:39PM PDT on May 15, 2013

Thank you. And i hope you're well now...

6:09PM PDT on Apr 13, 2013

I'm 67 and have never gotten a mammogram. Never will. The scientific evidence doesn't support benefit vs. risk. Women have been brainwashed and frightened about breast cancer by the healthcare industry. This is not to say that it isn't a horrible type of cancer. But the evidence indicates that a mammogram is like whistling in the dark. Some of the breast "health" advice from doctors is appalling. One surgeon seriously recommended several years back that the "breast buds" of female newborns be removed as a "preventive" measure. And the same doctors who browbeat women into getting mammograms are lax about taking women seriously when they have cardiac symptoms. Yet, heart disease is a bigger killer for women.

4:46PM PDT on Apr 13, 2013

I am strongly of the opinion that having a mamogram is abusing your body both in pressure & radiation. If men had to put their penis in this device, it would have been abolished long ago.

4:42AM PDT on Apr 13, 2013

I really think that the exposure to radiation simply can't be good. AND -- having had a false scare during which the biopsy was botched and had to be done again only to worry and then hear all was fine, does not encourage me to feel good about what once was considered a test
that was ultimately important. Certainly not every year and most of the women I know who have had breast cancer found the lump themselves.

10:52AM PST on Jan 2, 2012

In reading some of the comments, I see that breast screening with thermography comments include a reference to "lymph congestion." That would imply that the clinic performing and reading the thermogram was not within the FDA/HEW approval list for use of thermography. Thermography camera prices have come down significantly in the last couple of years enabling just about anyone to purchase one. There is no licensing, or regulation of thermography, only a list of approved uses. Consequently, it is definitely "Buyer Beware" when looking at clinics for thermograms. Often clinics will offer breast screening, then up-sell the patient into full body thermograms...seems like a good idea! Not necessarily. Breast screening with the proper protocol and adherence to environmental controls (two-series study with a cold challenge and specific temperatures shown within one screening in a 68 degree room is essential for the high level accuracy that has been researched) is particularly beneficial because the breasts are essentially a skin organ that respond to the environmental challenge, and contain specific vascularization for the mammary function that is interrupted when malignant tumors form. Thermography is effective for younger women with dense breast tissue. A questionable thermogram at low-level risk would be followed up with a 3-6 month repeat, a high-level risk score (should be numerical and list specific issues) should refer the patient to further testing, perhaps with mammogram and

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