Mammograms: How Effective Are They?

By Rachel Walden |

Tara Parker-Pope at the New York Times’s Well blog begins a recent post with a provocative question: Has the power of the mammogram been oversold?

It’s not a question that has been completely ignored – considerable debate erupted in late 2009 when the US Preventive Services Task Force released new guidelines recommending that women without higher risk wait until age 50 to begin routine mammograms.

Our Bodies Ourselves, the National Women’s Health Network and Breast Cancer Action all have previously raised concerns about the right timing and use of mammograms, especially in women without an elevated risk of breast cancer, but working against a popular myth that more mammograms sooner are always better for women’s health is a challenging task.

Parker-Pope explains:

…many doctors say it’s also time to set the record straight about mammography screening for breast cancer. While most agree that mammograms have a place in women’s health care, many doctors say widespread “Pink Ribbon” campaigns and patient testimonials have imbued the mammogram with a kind of magic it doesn’t have. Some patients are so committed to annual screenings they even begin to believe that regular mammograms actually prevent breast cancer, said Dr. Susan Love, a prominent women’s health advocate.

Her post also explains a study just released in the Archives of Internal Medicine, “Likelihood That a Woman With Screen-Detected Breast Cancer Has Had Her ‘Life Saved’ by That Screening.”

The Dartmouth researchers conducted a series of calculations estimating a woman’s 10-year risk of developing breast cancer and her 20-year risk of death, factoring in the added value of early detection based on data from various mammography screening trials as well as the benefits of improvements in treatment. Among the 60 percent of women with breast cancer who detected the disease by screening, only about 3 percent to 13 percent of them were actually helped by the test, the analysis concluded.

Translated into real numbers, that means screening mammography helps 4,000 to 18,000 women each year. Although those numbers are not inconsequential, they represent just a small portion of the 230,000 women given a breast cancer diagnosis each year, and a fraction of the 39 million women who undergo mammograms each year in the United States.

Do check out the rest of Parker-Pope’s post for further exploration of this controversial topic; the full text of the journal article has also been made available online for free.

Somewhat relatedly, Shira Sternberg writes at Public Responsibility in Medicine and Research’s Ampersand blog (no, not that Ampersand…) about breast cancer from her perspective as the daughter of daughter of “longtime PRIM&R friend” Pat Barr, who died of breast cancer eight years ago. Shira reminds us that there is still work to be done:

In 1991, 119 women died a day of breast cancer, today it is about the same, 110 women die daily of the disease. And this year alone over 230,000 women will be diagnosed with the disease. We gathered at the White House because we know we can do better.

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