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Despite Controversy, Experts Agree that Routine Mammograms Save Lives

Last fall, several scientists re-ignited a debate when they published an article critical of mammography. They asserted that numerous studies on mammography are flawed and that routine screening mammography aimed at detecting breast cancer does not actually save lives.

The issue has made headlines and may have confused women about what the general consensus on mammography actually is and what guidelines they should follow.

Medical professionals specializing in breast care at Loyola University Health System maintain that routine mammography can save lives because it is the best tool commonly available for detecting breast cancer at an early stage. 

Most scientists believe the studies give sufficient evidence to show that routine mammography saves lives. Studies have consistently shown that women who have routine mammograms at age 50 and older have approximately a 33 percent lower chance of dying from breast cancer than women who do not have mammograms.

“Most of the debate focuses on whether mammography is useful for women between ages 40 and 50. Research that has followed women for 15 to 20 years out shows that regular mammograms between ages 40 and 50 can lower a woman’s chance of dying from breast cancer by 19 percent in this age group,” said Karen J. Weiss, M.D., assistant professor of radiology and breast imaging specialist at Loyola University Chicago Stritch School of Medicine and Loyola University Health System.

Numerous organizations agree that, for most women, age 40 is a good time to start getting mammograms. The U.S. Preventive Services Task Force, an independent panel of experts in primary care and prevention, updated their 1996 recommendations for mammography screening this past February to include recommending that all women age 40 and older get routine mammograms. (Screening for Breast Cancer. Recommendations and Rationale, February 2002. Agency for Healthcare Research and Quality, Rockville, MD.). The American Cancer Society states its position clearly recommending that women 40 years of age and older have annual screening mammograms (American Cancer Society).

“These are good guidelines to follow,” said Weiss. “Women also should consult their primary care physicians about their specific breast cancer risk and when they should start obtaining a mammogram.” 

One of the biggest arguments against routine mammography is that some of the women who are screened will have a false positive result, which may cause unnecessary anxiety and tests. “Possible abnormalities that show up on the screening mammogram are usually evaluated more closely with a diagnostic mammogram, which gives a more detailed exam of a specific area, or a diagnostic ultrasound, which shows different characteristics of the lesion not shown on mammogram. Ultrasound is useful for problem solving and is not equal or better in detecting breast cancer than a mammogram. Ultrasound is not a screening modality and cannot find many small cancers that mammograms can detect,” Weiss noted.

With new techniques, biopsies themselves are less invasive now than they used to be. They are usually performed with a needle by a radiologist utilizing image guidance and are done in radiology rather than in an operating room. “Discomfort is reduced and recovery time is shortened. Women often go back to work the same day, “ Weiss said.

Breast cancer has a higher survival rate and better prognosis when detected at an early stage. Not all breast cancers are diagnosed through mammogram screening. Not all are diagnosed through clinical breast exams. “The combination of an annual screening mammogram and annual clinical breast exam is currently our best defense in the fight against breast cancer,” Weiss said.  Monthly breast self-exams can be helpful as well. These modalities and future technologies give us hope that we will win the fight against breast cancer.

For more information or to schedule a screening mammogram, call 1-708-CAN HELP.

Written by Tracy Binius and Heather Robine in collaboration with Karen J. Weiss, M.D., assistant professor of radiology and breast imaging specialist at Loyola University Chicago Stritch School of Medicine and Loyola University Health System.

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