Point of View

Clarity, not confusion: Mammograms save lives

February 26, 2014 

Here we go again. The confusion about mammography reached new heights last week with the release of a Canadian study that questions the value of this screening test. As a doctor who detects an abnormality, diagnoses breast cancer and discusses a scary diagnosis, I want to set the record straight for North Carolinian women: Mammograms save lives.

Women should talk to their physicians and not allow media hype or a flawed study to prevent them from getting this critical annual exam.

The early and accurate diagnosis of breast cancer is key to survival, and mammography is the gold standard for early detection. A mammogram is capable of detecting abnormal breast masses up to two years before they would be noticed through a manual breast exam.

Since 1990, when regular mammogram screenings became the norm for most women over 40, the mortality rate from breast cancer has dropped by 30 percent. Breast cancer survival improved when we started testing for it regularly. With regular screenings came earlier diagnoses and more effective treatments. Today, when breast cancer is detected before spreading to the lymph nodes, the five-year survival rate is 99 percent.

Improved survival explains why the American Cancer Society, American Congress of Obstetricians and Gynecologists, American College of Radiology, and Susan G. Komen for the Cure® still endorse annual breast cancer screening beginning at age 40 — even earlier if a woman is at greater risk for developing breast cancer.

Mammograms have improved over time. For decades, taking images directly on film was the main technique. Today, digital mammograms are the standard of care and are proven to be significantly more accurate than film. New advances like 3D mammograms make mammography even more accurate by improving the detection of invasive cancer by 40 percent and reducing false positives and unnecessary callbacks.

Mammography is indispensable in fighting breast cancer, so naturally a study claiming the opposite would cause headlines. A new study, published in the journal BMJ earlier this month and based on Canadian data, contradicts about a dozen other studies – and doctors’ every day practice – that show mammograms are lifesaving.

The paper relied on data more than 20 years old, as the researchers finished screening women in 1988, when outdated film mammography was the standard of care. The misrepresentations in the data are so severe that the American College of Radiology has warned policymakers against using the study because it might lead to conclusions that put women’s lives at risk.

It would be tragic if fewer women decided to get an annual mammogram out of the misunderstanding or confusion that this study has caused. Please don’t be confused. We can treat breast cancer only when we know it’s there. The evidence continues to show – overwhelmingly – that mammograms are the best tool to fight a disease that still strikes 1 in 8 women. Mammograms do save lives, and one of them could be yours.

Laura O. Thomas, M.D., is a radiologist in Raleigh.

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