Doctor Knows Breast: The Case For Mammograms
Prevention and Treatment When it comes to beating breast cancer, the early bird gets the worm.
It’s every woman’s worst nightmare — a ruthless and indiscriminate killer and the leading cause of death for women under 50 — but breast cancer can be defeated, it just takes some diligence and a brave face.
The real lifesaver for women with breast cancer is early detection; having regular mammography screenings can catch cancerous tumours even before symptoms begin.
Radiologist Dr. Jean Seely says there are benefits to early detection. “The cost of the treatment is lower by detecting it earlier and this has an impact on women’s lives — less time off work, better quality of living,” she says.
Dr. Seely says mammograms have the ability to detect tumours as small as a centimetre, half the size of growths that can be found during self-examination.
“If I detect a cancer that’s less than a centimetre, my chances of survival in the next five years are almost 100 percent,” says Dr. Seely. “If I wait until it’s two centimetres in size, my survival drops — it’s more like 80 percent.”
Risk of overdiagnosis
Mammography isn’t without criticism; the screening does carry the risk of over diagnosing in that it can sometimes detect non-harmful cancers that don’t need treatment.
Dr. Seely says overdiagnosis is certainly an issue, one that’s been studied for decades. “We’re detecting another 11 percent of breast cancers that would not otherwise cause harm,” she says. The problem is that there is no way to differentiate between tumours that will become invasive and those that will not, says Dr. Seely.
“The cost of the treatment is lower by detecting it earlier and this has an impact on women’s lives — less time off work, better quality of living.”
It puts pressure on women to make an educated decision on whether to take the risk and seek treatment. “I’ve had only one woman in the last 15 years tell me, ‘No, I want to wait to see what happens.’ Most women don’t want to take that risk,” she says.
The Canadian Association of Radiologists recommends that women 40 and older go for regular mammography screenings — the thought of which may make most women cringe — but it’s up to individual women to weigh the risks and benefits of the test. “Having the mammogram and getting the diagnosis of cancer does not have to be a death sentence,” says Dr. Seely. “It can lead to a really good outcome and it may save their lives”
The risk of getting cancer from radiation during screenings is also cause for anxiety for some women. “There’s almost a zero percent chance of having a breast cancer caused by the mammogram,” says Dr. Seely.
A recent study in the journal Cancer concluded that in the past 30 years, the rate of inoperable (locally advanced) breast cancer has decreased by 37 percent. It’s an encouraging result, one that should make more cautious women out of all of us.