One way to judge the value of a disease screening program -- such as annual screening mammograms for breast cancer -- is to figure out how many deaths will be prevented by the screening program.
A study estimates that screening mammograms save the lives of between 3% and 13% of all women aged 50 to 59 diagnosed with early-stage breast cancer.
The research was published online on Oct. 24, 2011 by the Archives of Internal Medicine.
The researchers said that because doctors now can successfully treat early-stage breast cancer, most women in their 50s who are diagnosed with early-stage breast cancer will survive, even if they didn't get annual mammograms and the cancer was diagnosed later when it could be felt by the patient or her doctor. The researchers also said that the results suggest that the value of annual mammogram screening is less certain than it was in the past when early-stage breast cancer treatments weren't as successful and many more women died from breast cancer.
In November 2009, the U.S. Preventive Services Task Force (USPSTF) recommended that routine screening mammograms for women with an average risk of breast cancer should start at age 50, instead of age 40. These recommended changes were very controversial and were not adopted. U.S. guidelines call for all women age 40 and older to have screening mammograms every year. While not ideal, some women may choose to have a screening mammogram every other year.
Like the conclusions of the experts who did this study, the recommendations of the USPSTF experts were based on a number of factors including:
- The cost of lives: the estimated number of lives that would have been lost if the screening were not done.
- The cost of screening: the actual cost of doing screening mammograms and interpreting them.
- The cost of false positives: a mammogram showing an abnormality that looks like cancer but that turns out to be normal. These costs include the expense of more tests (e.g., biopsies), follow-up visits, and possibly even treatment that isn't needed, along with the stress and worry about being diagnosed with breast cancer when there is no cancer.
Breastcancer.org acknowledges some of the arguments against routine mammograms but believes that the evidence against annual mammogram screening starting at age 40 is still not clear. Breastcancer.org believes that all medical decisions, including if and when to screen for breast cancer, should be made by each woman and her doctor based on the best available information and a woman's beliefs and preferences.
Breastcancer.org still recommends that if you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you should talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.
There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of your regular screening mammograms:
- If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
- If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
- If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.
For more information, visit the Breastcancer.org Mammograms pages.