Cancer Society Says, "Is That Mammogram Really Helpful?"

As if you couldn’t tell from all that pink spewed across the landscape, it’s National Breast Cancer Awareness Month. From this (and from me) you all know the drill: make that appointment, take those steps to reduce the discomfort, and GET THAT MAMMO!!

Um…but wait a minute. Now the American Cancer Society is saying that perhaps they’d been a little too hasty, with both mammograms and prostate screening. Perhaps we’ve been overscreening, and perhaps overtreating cancers that might not be deadly.

“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the ACS. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”

But…but…I’ve got my pink t-shirt. My pink ribbon pins. I strip to the waist and get my yearly mammograms and urge other women to do the same. Lots of men I know cowboy up and get their prostate screenings (PSAs). Now they’re saying…don’t sweat it?

Not exactly. While the ACS has concerns, they don’t want you to stop getting screened. But they want it made more clear that mammograms, while helpful, don’t tell the whole picture when it comes to breast cancer.

For instance, your films might reflect false positives that alarm patients and result in invasive biopsies. Or they could show small cancers that may not be life threatening. Sometimes doctors jump in and over treat these small tumors, subjecting your body to the ravages of chemotherapy and radiation. The ACS estimates (according to an article in the New York Times) that for every 100 women told they have breast cancer, nearly a third of those tumors are so slow-growing, they might never be harmful. And some cancers, found at an early stage, still end up becoming deadly.

Excuse me, but what the…?

According to Dr. Brawley, “the benefits of early detection are often overstated.” He wants to clarify that although screenings are still useful, and can save lives, the ACS has been putting out simplistic messages. They want people to know the limitations, benefits and risks of screening tests - that you could be over treated or undertreated. This, the ACS believes, will help researchers in their quest to improve the tests and even develop new ones.

He also said that “the issue here is, as we look at cancer medicine over the last 35 or 40 years, we have always worked to treat cancer or find cancer early. And we never sat back and actually thought, ‘Are we treating the cancers that need to be treated?’”

It’s a good question. One that you should ask your own doctor, if your mammogram comes back “abnormal.”

I share the concerns of some in the medical community that this admission could end up becoming a political football. Another headline discouraging women from getting tested. Another “damned if you do, damned if you don’t” issue for doctors. “Politically, it’s almost unacceptable,” said Dr. Peter Albertsen, chief and program director of the urology division at the University of Connecticut Health Center. “If you question overdiagnosis in breast cancer, you are against women. If you question overdiagnosis in prostate cancer, you are against men.”

Sigh.

I would still recommend that you get your regular screenings. Just know what you’re getting into. Talk to your doctor about all the risks and benefits. If something comes back questionable, ask him or her what it could be and what are the risks of treating versus not treating. Get a second opinion, if you'd like. Knowledge is power, after all. And so are all of those pink ribbons.

So…what do you think? Have you ever gotten a “false positive” on your mammo? Do you get them regularly? Or will you, when your doctor recommends that you start?