Guest: Are mammograms worth doing?
Mammograms still save lives through early detection of breast cancer, even though some studies have shown they can cause harm, writes guest columnist David Richart.
Special to The Times
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To learn more about understanding breast cancer and local breast health resources, please see komenpugetsound.org, or call (206) 633-0303.
YOU have probably heard that early detection of breast cancer and mammograms can save your life. On the other hand, recent studies, including a Journal of the American Medical Association report in April, claim that mammograms can also cause harm.
The risks include “false positives,” suspicious mammograms that lead to a repeat test or biopsy on a healthy breast. These false positives can result, and have resulted, in treating tumors that are not life-threatening.
To make the issue more complex, different agencies offer different guidelines for yearly mammograms. The U.S. Preventive Services Task Force suggests a woman should wait until she reaches 50 years old to begin routine mammograms, and then schedule mammograms once every two years. The American Cancer Society and Komen continue to recommend that annual mammography should begin at 40 years old for women of average risk.
So, what is a woman — or man — to do?
It comes down to the individual person. The balance of harm versus benefit varies by your age, your family history, your health and other factors that determine your individual risk of breast cancer.
This is why we strongly recommend you discuss with your doctor when to start or stop your routine mammograms, and whether this form of early detection is appropriate for you at all.
At Komen Puget Sound, we agree with the Journal of the American Medical Association study’s authors that women and health-care providers need better guidance to assess an individual’s risk for breast cancer and how to best approach detection of this disease.
Mammograms are imperfect. They are, after all, based on technology from the 1960s. We share the concern of the study’s authors about the potential for over-diagnosis and overtreatment. But, as reported in the JAMA study, the fact is that mammograms have saved lives.
Komen Puget Sound is the largest private funder of free mammograms in Washington state. Last year alone, Komen-funded mammograms detected breast cancer in 330 women in our community.
One of those women was Seattle resident Luisa Lavalle. Luisa noticed a lump in her breast but, having been recently laid off, she kept delaying getting a mammogram. Luckily, she learned of a free Komen-funded screening and took advantage of the opportunity. The screening results confirmed she did indeed have breast cancer. Within 20 days, she had the cancer removed and, because it was caught early, she didn’t require chemotherapy.
Luisa is young and her cancer was aggressive. Her doctors told her that had she waited even a few months longer the outcome would have been very different. If you ask Luisa about her mammogram, she will tell you it saved her life.
The need for more accurate, sensitive and cost-effective breast-cancer-screening tools is clear. Komen is currently investing in global medical research to develop these tools, including a Fred Hutchinson Cancer Research Center study into blood-based indicators.
Until these new approaches are widely available, however, mammograms continue to be the most widely available test for breast cancer that we have now.
David Richart became executive director of Komen Puget Sound in January.