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Mammograms: Should I Have One?

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When should you have a mammogram?

From 1990 to 2007, the risk to an average American woman of dying from breast cancer dropped 30 percent. Many reputable sources attribute this drop to three elements of modern health and medicine. First, treatments have improved. Second, there is greater awareness in the general public that any abnormality a woman finds regarding her breasts should be reported to her doctor. Third, screening tests (e.g. mammograms) and clinical exams (those conducted by health care professionals) find cancers earlier, giving treatment a better chance to succeed.

For decades, the American Cancer Society (ACS) and the National Cancer Institute have advocated annual screening mammograms for women 40 and older. In fact, the ACS website states “mammograms offer substantial benefit for women starting in their 40s.” (A screening mammogram is conducted as part of a routine exam, providing the doctor with X-rays from year to year that he or she can compare to check for changes or abnormalities in the breast tissue. A diagnostic mammogram is conducted after a screening mammogram has indicated an abnormality.)

To reiterate, women currently have three weapons available to them for use in the fight against breast cancer. These weapons are recommended by two agencies at the forefront of the war against this disease. The use of these weapons has yielded impressive results. So why are people beginning to question the effectiveness and necessity of mammograms for women between the ages of 40 and 50 (and even older)?

A Norwegian medical study conducted from 1996 to 2005, the results of which were published in the New England Journal of Medicine in September 2010, states that only a third of the reduction-in-deaths rate is actually attributable to mammograms. The study concluded that the increased awareness and the improved treatments now available factor more heavily into patients’ survival than mammograms, recommending women not begin their screenings until age 50, and then undergo them only once every two years.

The study went on to say that if 2,500 women were regularly screened over the course of ten years, one life would be saved because of the mammogram. It was the opinion of the authors of the study that this data does not support advocating mammograms for women between 40 and 50 years of age.

But what if that one person were you? or your mother? or your daughter?

More than 1 million women are diagnosed annually around the world with breast cancer. How many of those women were diagnosed because they had a mammogram? How many of them will have the benefit of early treatment because the mammogram caught the tumor before it grew large enough to feel from the outside?

Globally, more than 500,000 women die from breast cancer every year. How many of them did not have a mammogram at a time when the cancer could have been caught and treated effectively?

According to Dr. Otis Brawley, chief medical officer at ACS, of the women who should be getting regular mammograms, 35 to 40 percent of them are not. He attributes 20,000 to 40,000 breast cancer deaths over the next ten years to that lack of screening.

It’s a fact that mammograms catch breast cancer earlier than self-examinations do, before they can be felt during a routine or clinical breast exam. If the tumor is caught before it spreads to surrounding tissues and lymph nodes, survival rates are much higher.

There are those who believe that the danger from having regular mammograms – which are X-rays – outweighs any benefit from the screening. There are doctors who have conducted studies which say that more than 50 percent of cancer-related deaths are X-ray induced and that each mammogram increases a woman’s chance of getting breast cancer by 1 percent. These doctors do not recommend mammograms for regular screenings.

However, it is impossible to ignore the fact that both the American Cancer Society and the National Cancer Institute – even after the release of the Norwegian study in 2010 – still advocate mammograms for screening purposes beginning at age 40. They contend the benefits outweigh the risks.

As stated earlier, there are three weapons women have at their disposal when fighting the war against the most common form of cancer in women. These weapons, together, have been working. Even if the Norwegian study is right, and only one life out of 2,500 is saved, who is to say that life is not worth the test?

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