The mammogram debate is alive and well. Some people praise mammograms while others oppose the x-ray imaging system. Over the years, however, some cancer experts have even started to question the seemingly outdated and potentially harmful breast cancer screening method that is still so prevalent today.
But with so many institutions claiming that mammograms are important and absolutely necessary, it can be hard to hear the other side of the argument and alternative options. In particular, there are three areas that weâ€™ll explore in this article: whoâ€™s profiting, the problem with overdiagnosis, and the reality of existing research.
In the western world, there are generally two camps: camp A believes routine mammography screenings should happen by 40-or-50-years-old while camp B believes that routine tests are not necessary or essential. Why does this matter? Because breast cancer prevention is something that obviously should not be taken lightly. So, letâ€™s delve into the facts.
Who Profits from Early Mammogram Screening?
While breast cancer screenings are ultimately up to the individual, many women face a lot of pushback from personal health care providers. Youâ€™ve probably heard horror stories of doctors telling female patients that they canâ€™t be their doctor unless they agree to a mammogram. Why put a patient in that position? Possibly profit.
In the United States, there are a well-known companies and advocate groups for early mammography screening: the American College of Radiology and the National Breast Cancer Foundation, as well as Siemens and General Electric (who conveniently supplies and profits from most of the cancer screening-related devices).
Everyone can probably agree that these breast cancer awareness groups present a noble cause. However, because the major corporations involved endorse early mammography, it begs the question: â€œIs it possible for a nonprofit to maintain its integrity and critical stance about an industry that profits from the very social problem it is trying to solve?â€�
Is Breast Cancer Really Over-Diagnosed?
â€œThere are plenty of women in the position with people just telling them you need to have a mammogram every year,â€� says Dr. Michael LeFevre, the past chair of the U.S. Preventative Services Task Force (USPSTF). â€œI am somewhat embarrassed to admit that is still going on.â€�
In 2009, the USPSTF proposed changing the recommended breast cancer screening age of 50 to be lowered to 40. Although this suggestion was not immediately adopted, a growing body of research has helped to alter the guidelines, which is a mammogram every two years for women 50- to 74-years-old.
This 10-year change suggests that women are likely being over-diagnosed. In fact, researchers published a study in March 2017 in the Annals of Internal Medicine to determine whether or not breast cancer screening with mammography actually reduced advanced (i.e., bigger than 20mm) tumors from 1991 to 2010.
Taking place across Denmark, researchers compared breast cancer occurrence in two ways in areas with and without screening:
- Women aged 50 to 84 and
- Women aged 35 to 49, 50 to 69, and 70 to 84
The Studyâ€™s Findings
According to their results, researchers suggest â€œthat between one quarter to one third of breast tumors diagnosed in women who were offered screening mammography were over-diagnosed. In other words, these tumors would never have caused a noticeable health problem or led to death.â€�
You might wonder what makes that statement such a big deal, seeing as the mammogram(s) didnâ€™t really seem to lower the womenâ€™s quality of life. However, being diagnosed with breast cancer in the first place implies that numerous women likely received unnecessary and potentially harmful therapies (e.g., surgery, radiation, and/or chemotherapy).
Do Studies Prove That Early Breast Cancer Screenings Actually Benefit Women?
Advocates of getting mammograms done early are usually the same people to claim it will save your life. However, the main problem with such a claim is that it confuses â€œdisease specific mortalityâ€� with â€œoverall mortality.â€�
And for Oregon Health and Science University assistant professor, Vinay Prasad, overall mortality needs to be the benchmark that advocacy groups and medical professionals hold their screening-related claims to. Prasad actually claims there has never been a cancer screening proven to reduce overall mortality.
In fact, after reviewing 10 meta-analyses of cancer screening trials, researchers found that although a reduction in disease specific mortality was evident in 3 studies, 0 studies presented reductions in overall mortality.
Clearly, everyone could benefit from more research proving why or why not you could probably do without a mammogram. But for now, the best thing you can do is to be aware of the changes that are going on in your body and to talk to various experts who can help you navigate making this decision.
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