A review of 50 years of studies of mammograms released Tuesday finds that the benefits have often been overstated and the harms minimized — adding to the confusion about what remains an annual ritual for many American women.
But do the benefits of a mammogram outweigh the risks for you or your family members? That's a very personal question, and not one with an easy answer.
Each patient has different risks that should be discussed with a doctor, but here are answers to some of the questions raised by the latest research.
We're seeing a lot in the news about this. What should I know about this particular study?
The study published Tuesday looks at 50 years' worth of international studies. It reminds us that mammograms are not perfect tests and that the benefits of the screening are often overestimated, while harms are underestimated.
According to the review, mammography screening is associated with a 19 percent overall reduction in deaths from breast cancer. This rate was not the same for all women, however. It reduced deaths by only 15 percent for women in their 40s and about 32 percent for women in their 60s. All of this underscores what we already know: This is not a perfect test and there is no hard and fast rule for mammograms that fits every woman.
What are the risks of mammograms? Isn't it better safe than sorry?
This study finds that for a 40- or 50-year-old woman who gets an annual mammogram, the risk of getting a false positive over 10 years is 61 percent. That means that 61 out of 100 women will have a false positive test. False positives don't just cause emotional distress — they often require repeat imaging and can also mean more invasive procedures like a biopsy.
I'm 40 and healthy. Should I get a mammogram?
What this study shows is that there is not a one-size-fits-all approach to breast cancer screening. What is appropriate for one woman is not always appropriate for her mother or her best friend. Decisions about whether to have a mammogram should be made with your doctor and based on your individual risk for cancer.
Women with a higher risk of breast cancer based on family history or individual risk factors will benefit more from mammography than women of lower risk. Factors to consider include age, a history of cancer, genetic risk factors like the BRCA1 and BRCA2 genes, use of certain medications like some hormone replacement, increased alcohol use, obesity and not having a child before age 30.
We're seeing studies talking about the risk of mammograms. Why are doctors still using them?
Breast cancer kills 40,000 American women per year. At this point, mammograms are the best screening tool that we have. They aren't perfect, but used correctly, they can be lifesaving. However, doctors and researchers are working to develop better tools and one day these might replace mammograms.
Should I do breast self-exams?
While an awareness of your body is always a good idea, the evidence does not show that self-exam does a good job of detecting breast cancer. The U.S. Preventive Services Task Force recommends against teaching breast self-examination.
What age should women stop getting mammograms?
There is not enough evidence to recommend for or against mammograms after age 75, according to the task force. Another study published Tuesday suggests that this decision should be based on your life expectancy. For example, if your life expectancy is less than 10 years due to an illness, mammograms might not be the best choice. Again, it's an individual decision and should involve a thoughtful conversation and consideration of your unique medical profile.
First published April 1 2014, 1:01 PM