Doctors disagree with study on mammograms

A new Canadian study questions the long-term benefits of mammograms, but there may be some flaws in this research.

Regular mammography has been a staple of breast cancer screening for decades, but the Canadian study questions their value. They looked at almost 90,000 women over a five-year period and concluded there was no difference in deaths from breast cancer between those who received mammograms and those who did not.

Dr. Helen Cappuccino, a breast cancer surgeon at Roswell Park Cancer Institute, said, “The overall message is, I think, that discourages women from doing screening, and that concerns me because I’m a big proponent of screening and trying to detect breast cancer as early as possible.”

Tumors that are discovered earlier are more likely to be curable, and other large follow-up studies don’t agree with the Canadian report.

“There are many, many studies that document a decrease in mortality for women who undergo mammographic screening, period. That’s a simple declarative statement. There’s no question that mammography helps prevent breast cancer death,” Dr. Cappuccino said.

Doctors are not sure why there’s such a disagreement, but one reason could be technical differences in the mammography equipment from the 1980s to today. Small tumors would not have been discovered by a physical exam, or by the Canadian equipment.

Dr. Sara Majewski of Roswell Park Cancer Institute said, “I don’t think that you can compare the quality of the screen film studies that they had to what we have today. It’s just so much superior.”

And Dr. Cappuccino feels that each woman should consider her own risk and speak with her doctor about mammograms. She gets mammograms.

“My personal feeling is if there is cancer in a patient I would like to know about it. If I have cancer in my breast, I certainly want to know about it. I’d much rather have that treated and prevent it from progressing, rather than wait to see what happens,” she said.

Women at high risk should have more frequent mammograms. The National Cancer Institute has a simple questionnaire that will help a woman discover whether she is at high risk. You can find that here.

And though some are concerned about the radiation involved in mammograms, it is really a trivial amount. The dose is about the same as flying cross-country in an airplane at 30,000 feet.

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