Making sense of the mammography maelstrom

Are mammograms beneficial in detecting cancer? Should you skip them? Should you do breast self exams? Should you just leave it all to chance?

Just when you think you’re thoroughly confused over the latest news report about getting annual mammograms, another report comes out and confuses you even more. Are mammograms beneficial in detecting cancer? Should you skip them? Should you do breast self exams? Should you just leave it all to chance? If you’re as perplexed as most over seemingly conflicting information about mammograms, read on.

The most recent confusion erupted after a Canadian study found that mammograms may not save lives, but a closer look reveals those findings may not be so black-and-white.

“The issue with this study is it looks only at statistics related to survival — not at other factors that are important to most women, including choice in treatment options and quality of life,” said Natalie G. Stephens, M.D., medical director of the Norton Cancer Institute Breast Health Program. “When a woman is diagnosed with breast cancer in her 40s, completes treatment and carries on as wife, mother, daughter, teacher, friend, supporter — and does not die of the disease — that is meaningful. The study showed the same number of deaths due to breast cancer in the study groups over a 25-year period and that earlier screening did not decrease the death rate. However, cancer found on mammograms of women in the study tended to be detected when they were smaller, meaning more successful treatment options were available.”

According to the U.S. Food and Drug Administration, mammography still is the best tool doctors have to find breast cancer early, sometimes up to three years before it can be felt. Although mammograms are not perfect, they detect about 80 percent of cancers, which are good odds.

Another issue gaining media attention is that of “over-diagnosis” due to mammography. If a suspicious lesion is detected on a mammogram, the woman may be subjected to sometimes unnecessary biopsies, surgery, radiation and worry when some lesions may not ever develop into cancer. On the flip side, some of these cases could develop into cancer and taking action may save a woman’s life.

So, the answer to whether a woman should or should not get an annual screening mammogram lies with her personal preference, in conversation with her doctor. “It’s really a personal choice. No one can answer that question but you — you are in charge of your body and know yourself,” Dr. Stephens said. “Women should know, too, there is no question about the benefit of diagnostic mammography (used to investigate a suspicious finding), meaning if you have a symptom (lump, pain, drainage, skin change, etc.), get it checked.”

While reports in the media certainly can cause confusion, the bottom line is they shouldn’t cause you to steer clear of mammograms or self-exams — here’s why: Standard screening digital mammography in the U.S. detects tumors half the size of those found in the Canadian study. And for stage 1 breast cancer that hasn’t spread outside the breast, the five-year survival is 98.5 percent, according to Dr. Stephens.

Women should talk to their gynecologist or primary care physician about their family history, breast density noted on mammography and controllable (weight, diet, smoking, physical activity) and uncontrollable risks for breast cancer and then make an informed decision about both mammography and doing breast self exams.

The American Cancer Society still recommends women age 40 and older have yearly mammograms and clinical breast exams, and continue to do so for as long as they are in good health.

October is Breast Cancer Awareness Month

Do you know your breast cancer risk? Take an online assessment to learn your risk for developing breast cancer at

For more information about the Norton Cancer Institute Breast Health Program, call (502) 259-PINK.


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