Every generation has its version of “if we can…”. One of the most popular has always been, “if we can put a man on the moon, why can’t we cure the common cold?” Or, of significantly more interest, “why can’t we cure cancer?” Unfortunately, we have yet to manage to do either. The good news, however, is that, according to the American Cancer Society, the mortality rate for all types of cancer combined has fallen by 25% over the past 20 years.
The death rates for breast cancer have followed the same downward trajectory, steadily decreasing since 1989. Early screening, including mammograms, along with new and more effective treatment protocols are credited with this hopeful trend. Since the Breast Cancer Awareness campaigns were launched in 1985, early detection has been the mantra for healthcare professionals, activists and survivors. Mammograms have played a huge role in the crusade to save lives through early detection and treatment.
In the early 1900s, German surgeon Albert Salomon is credited with first using x-rays in an attempt to diagnose breast cancer. He recognized the importance of compressing the breast to get a clearer image. Many others followed with innovative improvements, but the concept is basically the same today. During a mammogram, the breasts are compressed between two flat surfaces, spreading the breast tissue out as much as possible during the x-ray in order to display a clear and detailed image on a computer screen.
Mammograms play an important role in early breast cancer screening by finding tumors too small to be found through a physical exam. By doing this, it is believed many lives are saved. Healthcare professionals and early detection advocates stress that finding the tumor as early as possible, while still small and contained, greatly increases the odds for successful treatment. Mammograms are also used as a diagnostic tool to help determine if there is breast cancer after a lump or other sign or symptom has been discovered.
While not exactly a pleasant procedure, a mammogram is relatively quick, generally lasting about 20 minutes. Some worry about radiation exposure, but it is actually very slight. The statistics for mammograms reducing the risk of dying as a result of breast cancer range from 25-40%. Most recommendations are that women should begin yearly mammograms at age 40, or earlier, if they are at high risk.
This brings us to the controversy that has surrounded the use of mammograms since 2009 when the U.S. Preventive Services Task Force recommended changing the starting age for women with average risk to age 50 instead of 40. Many argued that this was motivated by insurance companies not wanting to pay for the testing, but others voiced concerns that mammograms are not perfect and produce false negatives as well as false positives. Another faction argues that these tests result in over-diagnosis and over-treatment of conditions that would never pose a true health risk.
There was considerable push-back within the healthcare community. The American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the American Cancer Society, the National Cancer Institute and the National Comprehensive Cancer Network published guidelines stating that all women, regardless of perceived risk, should begin mammogram screening at age 40.
There is no arguing the life-saving potential of early detection through mammograms. However, the best advice is always to be your own health advocate. There’s far too much at stake in not being as knowledgeable about whatever issue you are dealing with, especially one as serious as cancer. The only decision that you should ever make when it comes to your healthcare is an informed decision.