Mammogram Screening & Prevention?
Updated: Jul 24, 2019
The usefulness of annual Mammogram screening for breast cancer prevention is again being called into question by an article released January 10th 2017 from the Annals of Internal Medicine. The 30 year study of Danish women aged 35 to 84 years old assessed the association between biennial screening, the size of detected tumors and the occurrence of over-diagnosis of breast cancer.
Conventional medical wisdom behind routine mammogram screening has been based on the idea that if you find a cancer early enough it will be easier to treat and prevent it from becoming an advanced and aggressive cancer. This study and several others have demonstrated that mammogram screening has led to an increase in diagnosis of breast cancers but it has not produced the expected drop in cases of advanced or late stage breast cancers.
Past studies have shown that women getting routine mammograms over many years have a higher rates of breast cancer than those who do not. Is it possible that the mammogram itself might actually stimulate breast cancer due to the x ray radiation? Another explanation is that not all early stage cancers need treatment and may resolve spontaneously if left alone. Once a tumor has been detected standard of care medical practice dictates interventions including surgery, radiation, chemotherapy and hormonal treatments.
Over Diagnosis and Over Treatment?
The Danish study echoes questions of other studies about over diagnosis and over treatment that do not have easy answers. The study estimated that over-diagnosis rates in the range of 14.7% to 38.6%. Some studies put the number as high as 52%! The study’s conclusion, “Breast cancer screening was not associated with a reduction in the incidence of advanced cancer. It is likely that 1 in every 3 invasive tumors and cases of Ductal Carcinoma In Situ (early stage cancer) diagnosed in women offered screening represent over-diagnosis”.
There are factors that shift the benefit of screening favorably, like a strong family history of breast cancer, use of hormone replacement, genetic mutations like BRCA, and age. Organizations that set the standards of care for preventive screening are even in contention about what the most prudent schedule is. It will take more study and time for conclusive evidence to be determined from these studies but patients are looking for answers and guidance now.
The beauty of naturopathic medicine is that it offers a myriad of options to prevent breast cancer beyond yearly mammograms. Studies like this serve reminder to empowered patients to have an active and informed voice in their healthcare.
If you are struggling with the decision to get a mammogram, please contact our office and let us help you determine a sensible course.