Do Screening Mammograms Save Lives?

Many individuals have heard of celebrities or other individuals who advocate for the benefits of screening mammograms in the fight against breast cancer. Some experts (and non-experts) have argued that the risks of screening mammograms outweigh the benefits, while others vehemently refute such assertions.

If you ask two experts if screening mammograms save lives, you can quite possibly get two different conflicting answers. Some research has shown that screening mammograms do save lives; other evidence has shown they do not. With so much conflicting scientific evidence it's quite likely that both experts are right and that screening mammograms do save some women's lives and they do not save other women's lives. To declare that screening mammograms have never saved any woman's life, not even one, is just as ridiculous of a claim as stating that all screening mammograms have saved the lives of all women who were ever screened. Unfortunately, it is impossible to predict in advance whose lives would be saved and whose lives would not.

One of the main arguments people use to defend the view that mammograms don't save lives is over-diagnosis. Over-diagnosis refers to the occurrence of finding breast cancers that would have never caused death or problems for the individual. Because mammograms find cancers that both would have caused death or harm to an individual and cancers that would not have caused death or harm during an individual's life, over-diagnosis becomes a concern.

We do not know with absolute certainty how many cases of breast cancer are over-diagnosed in the United States. Over-diagnosis is difficult to estimate -- studies vary, with recent estimates of approximately 20 percent. Please remember that if 20 percent of breast cancers are over-diagnosed, the remaining 80 percent were not and did require treatment. Technology must advance so doctors will know with certainty which cancers to treat and which to not treat.

Another argument against screening mammograms is that screening mammograms don't always identify breast cancers that are present. When your mammogram is found to be normal even though a cancer really is present, it is called a false-negative result. Evidence supports that breast cancers are missed on screening mammograms about 20 percent of the time, which means breast cancers are also correctly identified 80 percent of the time.

You may also hear that the radiation generated by screening mammograms may cause breast cancer. This risk is minimal. There are risks associated with everything we do in medicine; we must decide if the risks outweigh the benefits.

Bottom line: All women should discuss the risks and benefits of screening mammograms with their own doctors who they trust. If you like your mammogram, you should keep getting screening mammograms. If you don't like mammograms, then you shouldn't get one.

If you are a breast cancer survivor whose cancer was found through a routine screening mammogram, please tweet me a photo so I can retweet. #1LifeSaved #bcsm

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