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Health expert Dr. Rhonda Low clears up the confusion on when to get a mammogram
In 2009, the U.S. Preventative Services Task Force dropped its recommendations for women in their 40s to have routine mammograms, citing an increased risk of a false positive result in this age group. This was supported in 2011 by the Canadian Task Force on Preventative Health Care, which had long held this position and recommended routine screening for women aged 50 and over. Much debate ensued.
Then, in February 2014, more controversy resulted when a Canadian study published in the British Medical Journal received widespread coverage for suggesting that annual screening does not reduce breast cancer deaths, but rather leads to over-diagnosis and unnecessary treatment. Despite the fact this study reported results based on 25-year-old data and methodology that was widely criticized, it garnered a lot of media attention and spawned many opinion articles from experts both for and against screening mammography.
While mammograms are not perfect, they are still the best preventative measure we have against breast cancer. Here’s what you should consider before you get screened.
Early Detection Saves Lives
Studies from around the world have shown a minimum 15 per cent reduction in deaths for women who are screened regularly from age 40. Mammograms can usually find lumps two or three years before a doctor or self-examination. Early detection offers a better chance of cure and can avoid the adverse effects of treatments for more advanced disease.
A False Negative
A cancer could be missed, especially in women under the age of 50. Younger breast tissue can be dense, making abnormalities more difficult to detect. Knowing your own breast tissue and performing self-exams can help mitigate this risk.
A False Positive
There is the possibility of detecting a breast cancer and then having unnecessary treatment for something that may never have caused problems. However, science is not yet at a point to unequivocally know which cancers are “safe” to leave alone and which ones need treatment.
When you have a mammogram, only two pictures are taken of each breast: front and side views. So, on average, there is a seven per cent chance that you may be called back for more testing. Although this might cause some anxiety, in over 95 per cent of recalled women, no cancer is found. And in all my years of practice, not one of my patients has complained about the extra testing as they were ultimately relieved to have definitive results.
Exposure to Radiation
There is exposure to low levels of radiation with mammography; however, no breast cancers have ever been directly attributed to mammograms.
While all the controversy made headlines, experts at the B.C. Cancer Agency reviewed the data and produced their new screening recommendations earlier this year.
Age 40 to 74 High Risk
If you have a mother, sister or daughter with breast cancer, get a mammogram annually.
Age 40 to 49 Average Risk
If you don’t have a family history of breast cancer, you’re eligible every two years.
Age 50 to 74
It’s recommended you get a mammogram every two years.
Over age 74
You’re eligible every two to three years. Talk to your doctor.
Under age 40
A mammogram is not recommended unless you carry the BRCA1 or 2 gene mutation, have had chest-wall radiation or a strong family history of breast cancer. A doctor’s referral is necessary.
At the end of the day, almost all of my patients still choose to be regularly screened. While mammograms are not perfect, they are the best first line of defence we have.
The good news is there are are also a lot of things you can do to help lower your risk for developing breast cancer including: limiting your alcohol intake, not smoking, maintaining a healthy weight, being physically active. Here’s an excellent resource from the Mayo Clinic about breast cancer prevention.