A Difference of Opinion on Mammograms

[Celebration]

http://www.washingtonpost.com/wp-dyn/content/article/2009/11/20/AR2009112003718.html

I can imagine that the public might wonder why a procedure that prevents a disease would be taken away.

But mammography doesn't prevent breast cancer, it merely detects it. And detecting it earlier doesn't necessarily mean a life is saved or even extended.
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The idea of early detection is that we are catching cancer before it does damage. But we know now that this is not always the case, and sometimes we merely detect something that wouldn't have harmed a woman anyway. In other cases we are detecting a cancer earlier but can't change the course of the cancer. In this case, women and their families live longer knowing they have cancer, but they don't actually live longer than they would have if the cancer had been detected earlier.

Often I hear a woman say something like, "My life was saved by because of a mammogram I got when I was 39 and breast cancer was detected." But we don't know that her life was saved by that mammogram. She might have found the lump herself the next day, in the shower, or the cancer might have been an "in situ" cancer that would not have become invasive and might never have harmed her. It seems to her as if the mammogram "saved her life," but we cannot know that, and if one looks across many women in her age group, we don't see that on average this would be true.

In 1986, I found a breast lump that turned out to be breast cancer. I was 34. Because of my age, I had never had a mammogram. I sometimes wonder whether it would make just as compelling a sound bite if I said, "I found my own breast cancer without breast self-exam or mammography, and that's why I am still alive." While it is true that across populations taking early action against a breast cancer diagnosis saves lives, it is not always true that the method of detection can be credited. That is what the review is saying: Except in a few cases, we cannot credit mammography with saving women's lives in the 40-49 age group.

[MH1]

1. and isn't the radiation from mammography a potential hazard?

worth it perhaps if mammography is really making a difference in cancer detection and outcomes. But I've always thought once a year sounded excessive except for those already at high risk.

[Celebration]

2. that's one concern

Another concern is treatment that is too aggressive, and that also poses risks.

[supernova]

3. It's the cumulative effect over a lifetime

for radiation exposure.

For women, over the course of our lives, it's mammos and regular old chest x-rays, which are still pretty routine for other health concerns.

[Berry Cool]

4. I'm so glad this standpoint were made room for in the article.

Right now, the main people in the medical community who seem to be sticking with the "Mammograms save lives" message are the ones who stand to benefit from increased mammogram screening. Others are saying that we've been fed the media message of "early detection" for too long, and it's not right just because it's what we've been fed.

I saw a local news interview the other day where the anchor was interviewing someone from Komen for the Cure who was saying: Oh, no, we don't agree with these new guidelines at all! And the anchor was essentially saying to her: Oh no, I didn't think you would--I mean even I, as a man, know the drill: annual mammograms, monthly breast exams, early detection, yadda yadda yadda. OF COURSE that's what you're supposed to do! That's what EVERYONE has been saying for YEARS! It can't POSSIBLY be WRONG!

Well, that's not what I call journalism: a news anchor telling his guest that he agrees with her that a new piece of information that contradicts old information "must" be wrong because "everybody knows" the opposite is true. No, REAL journalism would be to say: What is your opinion of this information? If you disagree with it, why? And when you say why, you need a reason better than "This goes against the conventional wisdom our organization has dispensed for years; therefore, it must be wrong." After all, part of news is learning that conventional wisdom dispensed for years is, sometimes, wrong!

[Celebration]

5. eh, just wear a pink ribbon

and keep your mouth shut. No need for critical thinking.

:silly:

[Name removed]

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