Mammograms still best defense

The New York Times recently printed an article claiming that detecting breast cancer using low technology methods like a breast self exam are as good or better than mammograms.

It continued by claiming that breast self exams could even replace mammograms.

The article, published on Feb. 17, also implies that mammograms are no longer needed.

However, Dr. Kenneth Keller, physician and medical director for the radiology department at Trinity Health, said this national news story that bashes mammograms deserves consideration and appropriate responses. American women deserve no less as they make decisions about their breast screenings and overall health care, he added.

The medical professional response is one that exposes the shortcomings and flaws of a rationale suggesting that mammogram screenings in women 40 to 50 years of age should be questioned or even suspended, Keller said. Trinity Health and the American Cancer Society both recognize the benefit of mammograms, though, and both recommend yearly mammogram screenings after age 40. Nothing has changed in the current guidelines, he added.

Currently, the guidelines for breast cancer screening, according to Keller, any woman at a normal risk for breast cancer start mammography screening at age 40 and have annual screenings after age 40. It’s not very well understood or important for when to stop yearly screenings, he continued, but more important when women start getting screened.

Women who have a family history of breast cancer, like if their mother or sister had it, are at the biggest risk for getting breast cancer, Keller said. Also, if a woman started menstruating at an early age or who never had children are also at a slightly higher risk, he added. Women in the high risk category are encouraged to start getting mammography screenings starting in their 30s, Keller continued.

For those people who are concerned about the radiation level in mammograms, Keller offered some reassurance. “We know that X-rays of any kind will ionize radiation and will change the cell structure. Radiating tissue is bad, but it’s worked out in the body to heal the effects of radiation if it’s not severe. You can have a mammogram and not be afraid you’ll die.” Also, he added the risk is not worth worrying about because of the minuscule amount of radiation. “The amount of radiation from a mammogram is less than a pilot for Delta or for a mountain climber.”

Keller said the recommendations made in the New York Times article are based on bad science. The article continually refers to the Canadian National Breast Screening Study that was released more than 20 years ago and has been debunked many times, he continued. The Canadian health system is different from America’s health system, Keller pointed out, and the quality of mammogram images in Canada is terrible compared to what the United States offers. Recommendations made in the most recent New York Times article were based on poor quality mammography that used second hand machines that were not state-of-the art like they are today. The women in the study were also not properly selected or randomized.

“Respected doctors will point out the flaws of the study, but that doesn’t make the papers,” Keller said. However, the problem is that some women are not as well connected to their physicians, he added, or new immigrants who aren’t familiar with the language. National newspapers continue to publish information that is not in people’s best interest, Keller said, although he doesn’t call it faulty journalism since the information is just recorded by a reporter who thinks that if a doctor says it then it’s true.

According to Keller, one in eight women will get breast cancer in their lifetime. It’s a little higher now than in years’ past because detection technology has improved and the cancer can be found earlier, he continued, so women are dying less and less from it. The number of women who get breast cancer are living with it, Keller added, which is why the importance of getting yearly mammograms is a big deal.

The worst thing is that a woman will say she doesn’t have to get a mammogram because she read in the New York Times that you don’t have to get one, Keller said.

“Mammograms are still by far the best defense against breast cancer that we have, no question about it,” he added. “Don’t even think you can not get one and think you’ll be okay. Listen to what your physician says.”