Confused about Mammograms? Here is what you need to know.
An excellent op-ed in the Washington Post entitled “Don’t Worry Your Pretty Little Head About Breast Cancer” opines that the authors of the new American Cancer Society guidelines imply that women are simply unable to ‘handle the stress and anxiety’ surrounding mammography. Dr. Patrick Borgen, Chair of the Department of Surgery at Maimonides Medical Center and head of the Brooklyn Breast Cancer Center at the Maimonides Cancer AND Chair of Komen Greater NYC’s Medical Advisory Committee suggests that “the whole tone of the American Cancer Society document and the subsequent YouTube video by the lead author is patronizing and wholly unscientific.” A major reason given for the new guidelines is to decrease “stress and anxiety related to a possible diagnosis of cancer”. Dr. Borgen continues, “Women can handle stress and anxiety far better than men can (my opinion here) and 99% prefer a false negative to not catching a breast cancer at its earliest possible stage. In fact, a study in the British Medical Journal reported that 66% of women felt that 500 false positives would be acceptable for each life saved (30% felt that 10,000 false positives would be justified by one life saved).”
Fully half of the life years lost to breast cancer happen in the decade of the forties…as many as all life years lost from age 50 to 100. “There are several cogent arguments that can be made about cancer screening in general, says Dr. Borgen, shielding patients from the imagined stress of a false positive is not one of them.”
Komen’s response to the new guidelines is here. The extent to which the new ACS guidelines further add to the confusion of competing screening recommendations is regrettable. I encourage everyone to have a conversation about their personal health with their provider and decide on a screening schedule right for you. Too many women I know were diagnosed with breast cancer before age 45. The loss of even one of them due to delayed screening is too painful to even think about.