Is getting an annual mammogram a good thing or a bad thing? The latest and most comprehensive study every done puts into question the notion that mammograms save lives. This study was recently published in the British Medical Journal, February 11, 2014. It is believed that mammograms help identify breast cancers early and reduce deaths in women who receive them.
However this recent study disputes any statistically significant benefit to getting a mammogram with clinical breast exam in women 40 to 59 years old as compared to women who had clinical breast exams alone. This longitudinal study was done over 25 years on 90,000 Canadian women. The death rate was essentially the same in both groups. That’s right, in the women diagnosed with breast cancer, 500 women died who received mammograms versus 505 women who did not receive mammograms. Furthermore 1 in 424 women who received a mammogram were exposed to unnecessary surgery, chemotherapy and radiation due to over diagnosis.
Cancer researchers have recognized that some cancers are slow growing and others resolve on their own. Most breast cancers are found with mammograms, but as Dr. Anthony Miller, from the University of Toronto stated, “whether or not this is beneficial has now become very controversial”. Additionally there have been improvements in treatment, increasing survivability. In the February 11, 2014 article in the New York Times, Dr. Kalager, an epidemiologist and screening researcher at the University of Oslo and the Harvard School of Public Health stated, “with better treatments, like tamoxifen, it was less important to find cancers early”.
So what are women supposed to do in light of this new research? How should health care providers advise their patients? Should a mammogram become simply a diagnostic tool instead of a screening and diagnostic tool moving forward? This study as Dr. Kalager pointed out “does not support screening mammograms in women under the age of 60”.
Many women are concerned about the repeated exposure of their breasts every year to the radiation from mammograms. Now this study will certainly raise concern and confusion. Will this study result in a rapid decrease in the number of women getting mammograms? What do you think? For all the women out there, what are you going to do? If you are a health care provider, what are you going to recommend to your patients? There are women out there who quit getting mammograms years ago due to concerns about the safety of mammography. Many of these women have turned to thermography, feeling this is a safer alternative to mammograms for breast cancer screening.
Thermography is an infrared image that can pick up heat changes suggesting inflammation that is put off by precancerous and cancerous cells. Thermography is believed to be able to pick up abnormalities 8 to 10 years before it would be detected on a mammogram. So could thermography be used as a screening tool and mammography as a diagnostic tool? The FDA does not currently recommend the use of thermography for breast cancer screening or diagnosis. Furthermore, thermography is not widely accepted by conventional medicine.
There are arguments for and against thermography versus mammography. This latest research, certainly will insight further discussion around this controversial subject. Part of the argument against thermography is the lack of research. However, there actually was a great deal of research done in the 1970s and 1980s showing that thermography was very reliable. A 10-year study completed by Dr. Michel Gautherie, Ph.D and his colleagues in 1981 showed that an abnormal thermogram was, “10 times more significant as a future risk indicator for breast cancer than having a history of breast cancer in your family”. These researchers also reported that this study showed how 60 percent of the women later diagnosed with cancer had abnormal thermograms. This was due to the fact that thermal imaging, as previously metioned, can pick up cellular changes 8 to 10 years before it would show up on a mammogram.
Whether you are pro mammogram or pro thermogram, this study has certainly left many unsure of what to do. What do you think?