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The Dilemma of Mammography

How many of you just go and get your annual mammogram because it’s what you’re supposed to do?

How many of you just go and get your annual mammogram because it’s what you’re supposed to do? You don’t like it. You worry. You worry whether you get it or not. But most of you do it. And you do it because of the recommendations. The American Cancer Society and the American College of Radiology recommend every year starting at age 40. The American College of Obstetrics and Gynecology say every two years from 40-50 and yearly after that. The US Preventative Services Task Force is suggesting you ask your doctor between 40-49 and then every two years after 50. The Canadian Task Force and European Cancer Observatory now recommend screening every two or three years between 50 and 69. 

However, in 2013 The Cochrane Collaboration ( a body that accumulates all available evidence, sorts the good data from the bad and comes to a conclusion) found NO affect of routine screening in total cancer mortality and questioned whether routine mammography screening at any age was of any value. The Nordic Cochrane Collection also found screening to be “no longer effective”.

Can this be true? Are they really saying don’t look? Why? Early detection means earlier treatment and a better chance of a cure, right?

Well maybe not. There are a few good reasons for their conclusions and they are based on the rates of false positives, false negatives and the consequences of those results. Meta-analysis indicates a false negative rate of 10% and a false positive rate of over 50% with mammography. What this equates to is the bare fact that for every 2000 women screened for 10 years only one of those women will have her life saved, another 10 will be unnecessarily treated and will be living with the increased fear and stress of the diagnosis and side effects of therapy.

So what do you do?

It really comes down to the keystone of good medical practice. Every patient is a whole person and an individual. What is right for one patient is not necessarily right for another. Let’s talk and decide what is right for you.

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