Some cancer screening tests have been so well proven to save lives, like the colonoscopy, that if you don’t get one, you need more than your colon examined (to borrow from an old Cancer Society slogan about mammograms). But it’s now clear that mammograms don’t fit into guilt-trip status anymore. Using radiation to find lumps in the breast that are too small to feel with your hands has only a slight benefit.
Here are the numbers from the latest analysis in the New England Journal of Medicine. For every 2,500 women in the prime screening age group — 50 to 69 — you would need to give all 2,500 a mammogram at least every couple of years for ten years to save a single life. And in the process, 1,000 of the same women would turn up with a suspicious result, 500 of those would need a surgical biopsy, and five to fifteen of those would get cancers removed, and maybe entire breasts, that if left alone would never threaten the patient.
The medical journal analysis was written by Dartmouth medical school Dr. Gilbert Welch, who has long been a skeptic of the mammogram as a sacred cow of must-do medicine.
That means that the decision to have a screening mammogram is very much up to the individual. Some may want to take the risk of becoming an unnecessary patient to avoid the deadly but small risk of a preventable death from breast cancer. Others will prefer the option that seems to work better: Good vigilance and attention to small lumps, and then if a cancer develops, make sure you’re in the hands of a multi-disciplinary team of cancer doctors who specialize in the latest treatments.
Here’s an article by Gina Kolata about the latest study from Norway, in the New York Times.
And here’s what the National Breast Cancer Coalition has to say about the myths and truths of breast cancer.