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Women Shouldn’t Miss Mammograms
You may be surprised to learn that U.S. women are getting mammograms to screen for breast cancer at declining rates. While awareness about breast disease remains high, in some areas of the country, mammography procedure volume is actually dropping.
Couple that with the newly revised U.S. Preventive Services Task Force (USPSTF) guidelines for mammography screening and the outlook doesn’t bode well for women. The taskforce ups the age and reduces the frequency of screening to every other year for women between 50 and 74 years of age. The taskforce also doesn’t recommend breast self exams and clinical breast exams by physicians.
As a physician, this concerns me. The evidence supporting mammography is clear. Mammograms save lives. It is one of the major health care advances of our time. Since the onset of regular mammography screening of women ages 40 and older, the death rate from advanced breast cancer has decreased by 30 percent since 1990.
The new USPSTF recommendations could reverse this decline in breast cancer deaths, causing unnecessary suffering to women facing breast cancer and their families. The taskforce suggests more rigorous screening recommendations for women at high risk even though they represent a minority of breast cancer patients. Only rigorously screening high risk patients would mean missing 75 to 90 percent of breast cancers.
As a radiologist and a woman, I want to see patients referred to radiologists for the tests they need when they need them. These new guidelines send contradictory messages to women who have been educated about the importance of breast health.
Radiologists are like disease detectives—looking at images that tell us what is going on inside the body. When your physician orders a mammogram, it is a radiologist’s responsibility to read the image and give an interpretation to your physician.
Sometimes we never get the opportunity to help, because the patient chooses not to go for the test. Mammograms fall into this category.
Practicing in a large radiology practice, I often wonder about our patients. Could it be possible that there are women who will join a cancer survivor each year in a walk or a race to raise awareness about breast cancer, and yet be the person who has not had a mammogram in five years?
A mammogram is one of the big three (mammogram, Pap smear and colonoscopy) that should not be avoided. So, regardless of the reason, delaying a mammogram is not a good choice. Routine mammograms do save lives. Most abnormalities found early have the best chance for effective treatment. Early detection also can provide the least debilitating and invasive form of treatment, potentially avoiding a mastectomy and chemotherapy, to help preserve the quality of women’s lives.
The physician experts at Columbus Radiology share the opinions of the American Cancer Society, American College of Radiology and Society of Breast Imaging. As a women and doctor, I urge other women to continue to follow what you have always been told:
• Get an annual mammogram and a clinical breast exam by a doctor beginning at age 40.
• Consult with your doctor about more frequent and/or earlier screening if you are at a higher risk
for breast cancer.
• Talk to your doctor about the screening that is right for your individual needs.
• Continue to do breast self examinations.
As radiologists, we’re excited by where technology has taken us in women’s healthcare. In addition to the conventional mammogram, we are able to recommend advanced imaging options to physicians to aid in diagnoses and treatment, while also minimizing a woman’s exposure to radiation.
Having sophisticated technology and skilled radiologists is just part of the equation. Women need to be vigilant. Schedule an annual mammogram appointment and take control of your health. Follow your instincts and continue doing breast self examinations. If unsure of where to go or what technology is best for the test, consult your physician.
My advice is to manage your health as well as you manage other parts of your life. Invite someone to schedule on the same day and then go have lunch. It doesn’t have to be a bad or annoying experience. Take charge. Make your health a priority. And don’t forget to do a monthly self breast exam and always contact your physician if you have concerns.