“The Mammogram Myth”

Gayle Sulik has a great article on what she calls “The Mammogram Myth” up at Psychology Today.

“Following hundreds of thousands of women over long periods of time, randomized clinical trials have found that very few women, only about 15 percent, have their lives saved by routine mammogram screenings. Some studies put the screening-associated reduction as low as two percent. The problem is that some breast cancers don’t show up well on mammograms, or at all; some cancers, even though they may be small, have already spread throughout the body; and some of the most aggressive types of breast cancer show up between mammograms.

Although increased screening has led to an emphasis on early detection as the way to reduce cancer deaths, universal screening has not translated into a reduction in the number of invasive cancers (i.e., the types that have the capacity to spread and cause death). With rates of recurrence at 20 to 30 percent even 15 years or longer after diagnosis, an average prognosis of only one to three years for people whose cancer has spread to distant organs, and approximately 40 thousand deaths from the disease year after year, “early detection” does not accurately describe the scenario for most breast cancers. Yet, the seemingly unequivocal and unwavering support of some doctors, celebrities, radiology centers, and professional mouthpieces still promote a one-size-fits-all approach to breast cancer screening even when they fail to support diagnostic mammograms (i.e., those used to help make a diagnosis once signs or symptoms have already appeared).”

It’s clear that mammograms are not the panacea for detection and treatment that they initially seem. But once again, BRCA+ women are in a different situation than normal women when it comes to mammograms. Frequent screening pays off for BRCA+ women, as Stanford’s awesome Decision Tool for Women with BRCA Mutations shows.

Still, mammograms have their downsides for BRCA+ women. They’re uncomfortable, they’re expensive, they require insurance, they take time and energy, they are emotionally draining, and most importantly they don’t always detect cancer early, particularly in young women.

What’s more, the Mammogram Myth makes things more difficult for BRCA+ women because it gives the general population the impression that mammograms are enough to prevent or cure cancer. Many BRCA+ women have had well-meaning family members, friends, or acquaintances tell them the equivalent of “so you have a mutation, big deal. Just get more mammograms.”

My point here is that myths about the effectiveness of mammograms in general make life that much harder for BRCA+ women in particular. Moreover, as money pours into programs and propaganda that advance the mammogram myth, like those run by Komen, research that seeks to better diagnose and treat breast cancer are underfunded. As with some many things BRCA+, we need better options.


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