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Both Reuters Health and the Associated Press ran international stories on conflicting reports in the medical literature on the value of mammograms in the prevention of death from breast cancer. This is an important issue to Seabrookers because of the high incidence of breast cancer and the high mortality associated with breast cancer.  In 2002 the American Cancer Society estimates that there will be about 200,000 new cases and 40,000 deaths.  The incidence of new cases in this country is a little over 1 in 1000 per year.   A woman is likely to have a 1 in 8 chance of having breast cancer in her lifetime and breast cancer is the second (first is lung) leading cause of death among women.  The two widely publicized reports on mammography came to two different conclusions because they were based on very different approaches - one concluded that the jury was still out on the question of whether mammography saves lives and the other concluded that mammography cut the odds of dying of breast cancer by 16% among women in their 40s and up to 30% after 50. 
    
Who is at Risk?
Age is a risk factor - the older a woman the greater the chance that she will develop breast cancer: for example, the by age 30 the chance is 1 out of 2000, by 50 it is 1 out of 50 and by age 80 it is 1 out of 10.  While there are a great many advantages to growing old, especially on Seabrook, the odds of breast cancer do increase and one must be vigilant.  There are other risk factors, history of breast cancer, family history of breast cancer, certain genetic alterations and various breast changes.  Late menopause (after age 55) and not having children seem to be risk factors as well.  Anyone with one or more of these risk factors should see a physician once a year for a clinical breast physical exam and have a mammogram each year.  It is not controversial whether women at risk should have a mammogram each year or more frequently (twice a year)  - they should!
 
  
   "For women between the ages of 50- 69 there 
    is strong evidence that screening with
    mammograms on a regular basis reduces
    breast cancer deaths by 25 to 30 percent". 

 

What is a Mammogram and Why Shouldn't Women Have It?
A mammogram is a simple X-ray of the breast.  It takes about 20 minutes is uncomfortable for the 20 or so seconds that the breast is compressed, and it is interpreted by a radiologist - in the Charleston area by radiologists expert in the interpretation of breast films.  Mammograms will detect masses that could be tumor in women that cannot detect the mass by physical exam.  This leads to earlier detection and earlier detection is generally associated with higher cure rates.  These are the arguments for mammography.  Arguments against it are that it is expensive to a nation to screen all women over the age 40 (and insurance, medicaid, and medicare all pay for these tests.)  There are false negatives, meaning that some cancer escapes detection by mammography - it has been estimated that up to 20% can be missed.  There are many more false positives, meaning that masses are discovered on mammography, but found by biopsy not to be cancerous.  As many as 25% of "positive" mammograms in women over 50 turn out to be "negative" or benign masses.   This leads to anxiety, biopsy and other problems that would not have occurred had the woman not had a mammogram.  In other words one quarter of women will suffer emotional or even physical pain until the mammogram detected mass is declared a false alarm.  However, the National Cancer Institute estimates that for women in their forties , having mammograms on a regular basis reduces their chances of dying from breast cander by 16% and for older women (50 to 69) there is strong evidence that screening with mammograms on a regular basis reduces breast cancer deaths by 25 to 30 percent. 

What's a Woman to Do?
Even though mammograms are not perfect, they lead to both false negatives and positives, most agree that the reduce the risk of death from breast cancer, especially in older women. An annual mammogram and clinical breast exam by a physician are the best strategies to detect early and lead to breast cancer cure.  Meanwhile, the occasional study is likely to argue this point until more research is done to definitively answer the precise questions of who, at what age and how often should a woman receive mammography.

MUSCHealth.com Online Library Links:
Mammogram

Other Online Resources Related to Breast Cancer:
NIH- Senior Health Breast Cancer
Medline Plus Information on Breast Cancer
American Cancer Society
National Alliance of Breast Cancer Organizations
SHARE: Self-Help for Women With Breast or Ovarian Cancer
Y-ME National Organization for Breast Cancer Information and Support

Medline Interactive Patient Tutorials:
Tests and Diagnostic Procedures- Mamogram

MUSC Video Resources Related to Breast Cancer:
Breast Cancer
Find out about an innovative treatment for Breast Cancer called Mammosite. Interview with Dr. David Cole of Hollings Cancer Center.

Additional Online Resources Outside MUSCHealth.com:
(MedlinePlus, is an excellent source of health information from the world's largest medical library, the National Library of Medicine. Health professionals and consumers alike can depend on it for information that is authoritative and up to date. MedlinePlus has extensive information from the National Institutes of Health and other trusted sources on over 650 diseases and conditions.)

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