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My thoughts on the great mammogram debate, by Mitchell Spahn, MD
October 17, 2011
With all the recent developments in the news, it is getting increasingly difficult to understand when you are supposed to go in for your screening mammogram. Do you go every year? Every other? Do you start them at 40? Do you wait until you're 50?
The reason for most of the confusion started in November 2009 when the U.S. Preventive Services Task Force (USPSTF) updated its screening recommendations advising women at an average risk for breast cancer wait until 50 to start getting mammograms and then follow up only every two years.
The new guidelines started a debate within the medical community and don't match most mammogram recommendations from major medical organizations, including the American Cancer Society. These organizations and many physicians, myself included, still feel that women should be getting annual screening mammograms starting at 40 to best protect themselves from breast cancer.
So, why the difference?
The Task Force's major argument came from the likelihood of getting a false-positive mammogram result. A false-positive is when a patient is told there could be cancer, and then further testing shows that no cancer exists. False-positive results are more common for women ages 40 to 49 because their breast tissue is denser. As a woman ages, the density of her breasts tend to decrease, making it easier to find cancer.
However, breast cancer tends to grow faster and more aggressively in younger women. Also, the survival rate for breast cancer is 98 percent if it is found at its earliest and most treatable stage. This is why the American Cancer Society and other major medical associations have not changed their recommendations. This is why I still advise my patients to begin annual screenings at age 40.
Evidence clearly shows that mortality is reduced if you undergo an annual screening mammogram. Even women in their 40s get a 30 percent reduction in breast cancer mortality. I believe that a 30 percent reduction in the chance of dying from breast cancer makes it worth going in for an annual mammogram beginning at age 40.
Also, at Madison County Hospital, there is no reason you shouldn't be able to get your annual screening mammogram. Thanks to support from the Columbus Affiliate of Susan G. Komen for the Cure, The Battelle Breast Care Center at MCH offers Breast Care Clinics which provide mammograms at no out-of-pocket cost. All you have to do to make an appointment is call 740-845-7100 and refer to the Breast Care Clinic.
If you have any other concerns about starting routine mammograms, please speak with your physician. It is better to have a conversation about your concerns than to let fear keep you from getting screened.
As I have heard from many of the breast cancer survivors in our community, "Get a mammogram. It could save your life."