Is There Such Thing as Too Much Mammography? Essay Sample

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Mammography is a type of x-ray used specifically for breast cancer screening and diagnosis. It is the most reliable radiographic technique for early detection of breast cancer[1]. A mammogram is preformed by pressing the breast in between two specifically designed plates. For a screening test each breast is x-rayed twice, once from a vertical angle and once from a horizontal angle. For a diagnostic test one (or both) breast(s) is x-rayed from several different angles. As with many other medical tests, mammography is not 100% accurate. Doctors have been recommending regular screenings for years, but recently there has been a lot of debate over the risk involved.

It is true that early screening provides early detection and treatment of breast cancer, possibly meaning that the tumour can be removed before it bursts[2] and spreads. Regular screening gives physicians the ability to detect small tumours that may not be able to be felt in self-examination. Also a specific type of tissue growth called DCIS[3] which is a small abnormality confined to the milk ducts, can only be detected by mammography. If removed at this stage they cannot harm patients.[4]

Dr. H. Gilbert Welsh and Brittney A. Frankel, two Dartmouth researchers, did a study and concluded that even considering these benefits; it is true that there are a relatively low percentage of women who have found mammography useful. Dr. Welsh’s notes that of 138,000 women who are diagnosed with breast cancer due to mammography; 120,000 to 134,000 are not helped by the screening. “The presumption is that anyone who has had cancer detected has survived because of this test, “ said Dr. Welsh “…in screen-detected breast and prostate cancer survivors are more likely to have been over diagnosed than actually helped by the test.”[5] Also 10 out of every 100 women screened will be told that something on their test look suspicious[6], leading, not only to unnecessary emotional trauma, but to several other tests such as a MRI[7], which is a lengthy and uncomfortable test.

Now this is not going out to say that women should not go out and get a mammogram, but that they should be conscious of their mammographic decisions and they should be careful of how many mammograms they receive. The USPSTF[8] issued a guideline in November 2009 that suggested that women ages 40-49 should discuss the risks and benefits of mammography with their doctor and they should be given individualized mammographic recommendations, taking into consideration things like family history. Then at the age of 50, they should start to have mammograms every 2 years until the age of 74; henceforth reducing the amount of mammograms she will receive in her life by 22.[9]

Dr. Andrea Bradd is a British doctor presently living in Barbados, she worked in radiology and subsequently; mammography. When asked about the debate centring whether mammography is worth the cost and risks she said that she was in support of mammography being used, but in moderation. She acknowledged that, statistically, there is only a small amount of people who have been benefitted by the treatment but, as the equipment is getting better all the time and she believes that they’ve finally reached the point where they have the right age range for screening, she believes that the results can become much more accurate. When asked about other breast cancer screening methods she mentioned ultrasound and MRI; ultrasound being a safer test, because it involves less radiation, but you are only able to screen about a tenth of the breast at a time, so it is hard for doctors to stitch all the images together to form one image of the breast and have it still be reliable, MRI as aforementioned is a long process, approximately 30 minutes, that is uncomfortable and costly. So there are other methods of screening, but mammography outplays them in cost, comfort and reliability. In short she believes that mammography is the best method for early detection and a good thing, when used in moderation; no more than one every three years unless recommended by a doctor.

In conclusion I do believe that the benefits of mammography outweigh the risks. Although the risks may seem more in number, if doctors educate women and create a good plan based on their personal needs there is so much more to be benefitted instead of lost. There is a better chance, even if it is just slight, that the earlier the cancer is detected the earlier it can be treated and the less damage it can do, it may just be that little bit of time that makes all the difference in the end. My rationale is, even if there is a slight amount of over testing, if it was my own mother I would rather her have 20 false positives than her have breast cancer that wasn’t detected in time.

References:

[1] Santacroce, Luigi, Serdar H. Ural, Valeria Latorre, Tommaso Losacco, and Lee P. Shulman. “Read What Your Physician Is Reading on Medscape.” EMedicineHealth. Ed. Richard Harrigan and Fransisco Talavera. 27 Oct. 2005. Web. 20 Feb. 2012. <http://www.emedicinehealth.com/mammogram/article_em.htm>.

[2] Breast cancer generally forms in a smaller, hard, egg like sack that eventually bursts, spreading the cancerous cells throughout the breast

[3] Ductal carcinoma in situ

[4] “Mammography.” (Mammogram). 24 June 2011. Web. 20 Feb. 2012. <http://www.radiologyinfo.org/en/info.cfm?pg=mammo>.

[5] Parker-Pope, Tara. “Mammograms: Pros and Cons.” WeeksMD ». 26 Oct. 2011. Web. 20 Feb. 2012. <http://weeksmd.com/2011/10/mammograms-pros-and-cons/>.

[6] Whitaker, Julian. “The Pros and Cons of Mammograms.” Dr. Whitaker, Alternative Health Pioneer. Web. 20 Feb. 2012. <http://www.drwhitaker.com/the-pros-and-cons-of-mammograms>.

[7] Magnetic Resonance Imaging

[8] U.S. Preventative Services Task Force

[9] Doheny, Kathleen. “Researchers Question Mammogram Guidelines.” WebMD. WebMD, 02 May 2011. Web. 20 Feb. 2012. <http://www.webmd.com/breast-cancer/news/20110502/researchers-question-mammogram-guidelines>.

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