To Mammogram or Not to Mammogram? A note on recent studies

March 10, 2014 Swedish Blogger

A Canadian medical research study has recently been published questioning the value of doing screening mammograms on women in their forties. The article has spurred controversy because the results contradict multiple other similar research studies which showed that women in that age group who get regular mammograms actually are spared death from breast cancer more often that women who are not invited to screening.

Some problems with the methods of Canadian study, published in the journal BMJ, were pointed out by a scientist at the University of Washington, Judith Malmgren, who has worked with Swedish Medical Center doctors to see how women in their forties have fared in our system. Click here to read Dr. Malmgren’s letter to the editor of BMJ.

There are two ironic features to the Canadian study. First, the authors say it is okay for women to not get screening starting in their forties “when adjuvant therapy for breast cancer is readily available.” This means that it is okay to diagnose breast cancer later because you can mop up bigger and more advanced cancers with treatment like chemotherapy, radiation and bigger surgery. But at Swedish, we do not think that many women prefer more severe therapy rather than earlier detection.

Secondly, the authors conclude with the statement that we should still try to diagnose tumors when they are “at or less than 2 cm.” But to do this most easily, you would want to have a regular mammogram. If you find your cancer by feeling it, it is likely to be bigger than if it is found on a mammogram.

At the Swedish Cancer Institute, we endorse the breast cancer screening guidelines of the American Cancer Society:

  • Starting at age forty, have an annual mammogram

  • Have an annual breast exam by your doctor or nurse

  • Do breast self-examination

  • For women with a risk of greater than 20% above average,  consider breast magnetic resonance imaging for screening as well

For the majority of women, annual screening mammograms show no signs of cancer, but for other women there will be areas of concern needing additional work up. Some of these women will undergo additional studies or tests to find out they do not have cancer and others will begin their breast cancer journey. Our team strives to reduce the number of unnecessary procedures for benign conditions while identifying cancers at the earliest stages. Many of our patients express their appreciation for the continuity of care they receive year after year and the sense of relief they feel knowing we are monitoring their breast health. Screening mammography is an important tool for early detection of breast cancer.
For additional information about our breast program, call 206-215-5900 or toll free 1-855-878-3287. You can also visit our True Family Women’s Cancer Center webpage.

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