A recent Google hangout – “Let’s Talk Mammo“ – gathered a panel of experts to address confusion around conflicting mammography studies and increase awareness around breast cancer, inform patients about mammography and discuss common misperceptions about the technology. The overall aim was to emphasize the importance of early breast cancer detection and help women make informed decisions about their personal breast health.
Moderator of the session Carol Evans, CEO of Working Mother began by asking the panel about the recent studies questioning the effectiveness of mammography and whether reducing the frequency of screening was a good idea. The view of the panel was that screening was wholly beneficial.
“Seven out of eight recent studies have shown benefits to undergoing a mammography exam.¹ The one study that showed no benefits may have had problems with randomization of the subjects and therefore showed no difference in mortality,”² said Dr. Etta Pisano.
“Screening does save lives. Even more recent studies have shown a 25-50% reduction in breast cancer mortality for women between 40-70,” she added.
Dr. Martin Yaffe stated that: “There have been huge technical improvements over the past 30 years. Modern mammography can find up to 80-85% of cancers but it’s not perfect. Approximately 10% of women need to come back for a repeat screening.”³
When the panel was then asked about what women should keep in mind when hearing conflicting reports about mammograms, the panel was quick to acknowledge the power of personal experiences. Many women decide on whether to attend screenings based on previous visits or experiences of friends or family.
“Women are influenced by the data but also are influenced by personal experiences,” said Dr. Joseph Russo. “They should know that mammography has ushered in an era of breast health that wasn’t available to their mothers and grandmothers and it is a medical success story.”
Carol’s next question served to emphasize this point as she asked the panel what were some of the reasons why women avoided getting a mammogram.
“Most of the answers we get are fear-based said panelist Douglas Feil. “They’re scared of the pain or discomfort. Cost is also a big deal, they may not be insured.”
One surprising answer that Feil revealed was that women preferred to be kept in the dark as knowing meant they had to undergo treatment that they could ill afford.
The theme of whether mammogram benefits outweighed its risks or disadvantages was the next topic of discussion. Dr. Connie Lehman spoke passionately about this commenting that women, who have been called back for a second screening would have had the disadvantage of experiencing unnecessary anxiety. It is a difficult time for some women. However, doctors feel that this anxiety is offset by the screening program detecting breast cancers early on in their development. Very early breast cancers are usually easier to treat, may need less treatment, and are more likely to be cured.
“The risks involve callbacks and false positives. In about 10% of women we’ll call them back so we can get a couple more views,” she explained. “Some of them may need an ultrasound. What I tell women is the benefits far outweigh the risks.”
The session concluded when Carol revealed the results of a poll aimed at the Twitter users attending the session. She had asked them: “Based on the recent studies questioning the effectiveness of mammography, do you plan to reduce the frequency of mammograms?”
She revealed that 100% of respondents did not plan to reduce their frequency of mammogram screenings.
¹ Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening. Lancet. 2012;380(9855):1778-1786.
² Boyd NF, Jong RA, YaffeMJ, et al. A critical appraisal of the Canadian National Breast Cancer Screening Study. Radiology. 1993;189(3):661-663.
³ Screening Mammography Program 2012 Annual Report, 26, Feb., 2013