"Early Stage vs Advanced Stage - battle of the diagnosis"
We've heard this story before: Are mammography necessary, what if you are over 40 and what are the cost in terms of false positives. Several large studies, including a review by the U.S. Preventive Services Task Force in 2009 and a study on the causes of death in the United Kingdom in 2013, have questioned the value of screening mammograms.
Doctors who question the value of mammograms say that while mammograms do save lives, for each breast cancer death prevented, three to four women are overdiagnosed. Overdiagnosis means either:
- A screening mammogram finds a suspicious area that would have been eventually diagnosed as cancer by other means, without any effect on prognosis
- A screening mammogram finds a suspicious area that never would have affected a woman’s health if it hadn’t been found or treated
False positive results from screening mammograms also have helped fuel the debate about the value of breast cancer screening. When a mammogram shows an abnormal area that looks like a cancer but turns out to be normal, it’s called a false positive. Ultimately the news is good: no breast cancer. But the suspicious area usually requires follow-up with more than one doctor, extra tests, and extra procedures, including a possible biopsy. There are psychological, physical, and economic costs that come with a false positive.
"These studies and the resulting stories in the media have fueled an ongoing debate about the value of screening mammograms. "
A study done by researchers at the University of Michigan has found that in the 30 years since mammography was introduced, fewer advanced-stage breast cancers are being diagnosed. Researchers looked in the SEER database to find the number of diagnoses of early-stage and advanced-stage breast cancers between 1977 and 1979, before mammography became a standard screening test. They compared these numbers to the number of early-stage and advanced-stage breast cancers diagnosed between 2007 and 2009. SEER databases are large registries of cancer cases from sources throughout the United States maintained by the National Institutes of Health.
However, in the paper, the researchers said that this decrease in advanced-stage diagnoses and increase in early-stage diagnoses is what we would expect to see with a successful screening program. This means mammograms are finding more breast cancers early, when they may be less complicated to treat. The study also found that since mammography was introduced, there has been an overall 9% decrease in invasive breast cancer. This decrease has been offset by an increase in diagnoses of DCIS (ductal carcinoma in situ), which isn’t invasive.
There's only one of you and you deserve the best care possible. Don't let any obstacles, including fear of a false positive, get in the way of your regular screening mammograms:
- If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
- If you're having problems scheduling a mammogram, call the Illinois Breast & Cervical Cancer Program (1-888-522-1282), Stand Against Cancer (1-888-722-4673) or Access Community Health Network (1-866-882-2237). These are all programs designed to assist women in Illinois and the greater Chicagoland area
- If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.
SOURCE: Breastcancer.org - Article Published July 10, 2014