A well-written and balanced article on mammography from USA Today may help move the conversation about this screening test away from hype and a bit closer to reality. The title – “Mammogram is ‘terribly imperfect’, though recommended.”
For women in their 40s, mammograms reduce the risk of dying from breast cancer by about 15%… But mammograms miss some cancers and raise false alarms about others, causing women to go through unnecessary follow-up tests… “We’re saying, ‘Mammography is a terribly imperfect test, but we’re recommending women get it,'” Brawley says. “The task force was saying, ‘Mammography is a terribly imperfect test, and women have to make a decision about whether to get it in their 40s.'”
I encourage all women to read and share this article.
What I love about the article is how clearly written, non-inflammatory and concise it is, proving that the mainstream media can get it right when it comes to health information. The article also includes a fabulous summary graph that is simple to interpret and very clearly conveys just what it is mammograms can and cannot do when it comes to preventing deaths from breast cancer.
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More reading on mammograms from TBTAM and elsewhere
- The New Mammogram Guidelines – What you need to know.
- Another well-done story, by CNN, on the mammogram controversy
- Mammograms – what women want. But is it for the right reasons?
- ACOG’s Mammogram recommendations – not what you’d think
- Preventing Breast Cancer Deaths – How much credit does mammography get?
- USPSTF breast cancer screening recommendations
- American Cancer Society response to the USPSTF Mammogram Guidelines
- American College of Radiology response to the USPSTF guidelines
- The Secret History of Mammography – by Devra Davis, pHd at Huff Post.
- Mammogram Math at the NY Times – Understanding the numbers
- The Numbers Guy at the WSJ looks at the data.
- USA Today looks at breast cancer mortality numbers in women ages 40-49
- The Mammogram Post-Mortem by Dr Val – an insightful analysis of the media meltdown
- NPR, Dr Isis and Orac on the USPSTF Guidelines and African American Women
I had my first, “You should get a mammogram” conversation with my doctor this summer. “We like to get a baseline,” she said. I scrunched up my face like a child and said, “Do I *have* tooooo?” And then I said, “OH! I’m still breastfeeding! Do I get a pass until I’m done with that?” She said yeah, and we didn’t talk any more about it.
I’m 36, and have read a lot about when to get them, or not get them, and I’m a terribly non-compliant patient, and I hate screenings in general, though I do understand that they have their place, so I’m pleased to have avoided one this year.
I have a question about this sentence in the article: “In a group of 10,000 women screened with mammograms… up to 50 will get unnecessary treatment because a mammogram detects a slow-growing tumor of a type that would never prove life-threatening, she says.”
This matter of unnecessary or excessive treatment is then repeated in the penultimate paragraph: “…therapies such as surgery, radiation, chemo and long-term hormone pills can mean serious, long-term side effects, Warner says.”
What about the pathology report, what about the Oncotype Dx test? This article suggests doctors have no tools for distinguishing between types of tumors!
I’ve seen this suggested in other articles too. It seems a dangerously misleading omission. Or am I missing the point, somehow? (Are some women rushed into treatment without adequate testing on their particular tumor?) What’s your take on this?
I believe they are referring primarily to DCIS. There is widespread concern that this condition is being over treated – Wanda Sykes is not unusual in her decision to have double mastectomy for this lesion, the natural history of which we still don’t know.
Elaine Shattner and Romanoa Bates have done recent posts on DCIS
http://www.medicallessons.net/2011/10/more-on-dcis/
http://rlbatesmd.blogspot.com/2011/09/skyes-preventive-double-mastectomy.html
Thanks for reading.
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