Mammograms - Good or Bad?

For a while now, a major controversy about breast cancer is mammogram screening of whether or not it does more harm than good. Basically, a mammogram is an x-ray picture of the breast for women (or men, but some people argue otherwise) from ages 40-74 to detect breast cancer despite having any signs/symptoms or not (2).

Experiments have proved that mammograms cause several potential harms. These include: 

1)    Mammography screenings can also detect non-lethal cancers which tend to be smaller and grow slower. These cancers are not deadly; however, since the x-rays cannot differentiate lethal from non-lethal cancers, doctors tend to treat them all (2).

2)       Next, mammogram screenings can be incorrect because they can “miss up to 20% of breast cancer that is present at the time of screening (1).” It can cause false negative results which usually occur due to very dense breasts typically at a younger age or false positive results which is usually due to previous breasts biopsies, family history, and younger women (1).

Both of these factors can lead to “over diagnosis and excessive treatment,” which include surgery, radiation, hormonal therapy, chemotherapy, etc. all of which some women could have avoided had the mammogram screening been more accurate and precise.

On the contrary, mammogram screenings would be beneficial because of early detection. This would mean that if breast cancer was present, treatment would be able to begin immediately before the cancerous cells start to spread (1).

There have been eight major scientific studies in regards to mammogram screenings. Some of the studies methods were poorly conducted; however, two of them provided the most reliable data which included the Malmo and Canadian trials. Of these two trials, they found that the death rate of breast cancer patients whether given mammogram screenings or not were the same (2, 3). However, results from randomized clinical trials have shown that mammogram screenings have reduced breast cancer death rates for women of ages 40 to 74, especially after age 50 (1).

A very small proportion, 6%, of women actually knows about “cancers that do not progress or become life-threatening (2),” as they only receive information that mammography saves lives. I believe that if women were more aware of the potential harms, they would be able to make more sound judgements. In my opinion, I think mammogram screenings are needed. How would a person know if they have breast cancer if there is no visible sign or any symptoms? I still believe that women should have these x-rays done and as recommended, 1 to 2 years (1). However, now that we know about the risks, we can take some precautions. This could include waiting until you are at least 40 years old to lower the chances of receiving false results, attending a high quality mammogram facility, and not jumping to conclusions. We know that mammography is not always accurate so take a step back and speak with your doctor or health care provider and see if the x-ray is indeed accurate before beginning treatment. These small tweaks in how we view mammography, I think, would reduce the breast cancer death rate which would support mammogram screenings.

So what do you think? Are mammograms good or bad?

Resources:
1) http://www.cancer.gov/cancertopics/factsheet/detection/mammograms

2) http://medicalconsumers.org/2005/09/01/breast-cancer-awareness-month-read-this-before-you-have-a-mammogram/

3) http://www.knowbreastcancer.org/controversies/mammography-screening/