There has been a lot of confusion recently about the value of mammograms in early detection of breast cancer. Typically, public health groups such as the American Cancer Society recommend all women 40 and over have a mammogram performed annually. Some recent studies have called into question whether this approach may lead to overdiagnosis and overtreatment of breast cancer.
In July, the Journal of the American Medical Association published a study that examined data from more than 16 million women examined for breast cancer during the year 2000. Approximately 53,000 women from this group were diagnosed with breast cancer. After reviewing 10 years of follow-up data on their treatment, the study’s authors reached some surprising conclusions. While mammograms did result in the diagnosis of additional small cancers, there was no “decline in the detection of larger cancers.” In other words, aggressive mammogram screenings did not lead to a significant decrease in the overall number of breast cancer-related deaths. This led the authors to conclude there was widespread overdiagnosis of breast cancer.
Similarly, an April study published by Health Affairs noted there has been a significant increase in false-positive mammography findings and breast cancer over-diagnosis. The authors of this study, Mei-Sing Ong and Kenneth D. Mandl, reviewed data from over 700,000 insured women who received mammograms between 2011 and 2013. They concluded overdiagnosis occurs in between 22 and 31 percent of cases, which result in a total cost of over $4 billion annually, a much higher figure than previously estimated.
How to Avoid a Breast Cancer Misdiagnosis or Delayed Diagnosis
While an over-diagnosis can disrupt your life, a misdiagnosis or delayed diagnosis can be devastating. It’s important for you to discuss with your doctor the appropriate intervals for you to have breast cancer screenings given your age, health and family history. There are many things that may cause a misdiagnosis or delayed diagnosis of breast cancer.
First, you may discover a lump in your breast but a subsequent mammogram is negative. In such cases, it may be necessary to perform additional tests, such as an ultrasound, to definitely rule out cancer. If your physician fails to follow-up or order further tests, there may be a substantial delay in properly diagnosing breast cancer. Second, there are also many cases where a physician or radiologist misreads a mammogram, ultrasound, or even a biopsy, leading to a false negative or positive.
It is important to speak with your physician about the benefits and limitations of mammograms. Your doctor can also advise you if you are in an especially high-risk group for breast cancer. If you have any concerns about a missed or incorrect diagnosis, you should speak with your health care provider immediately. You should also obtain copies of your medical records.
Know Your Body by Doing Self Breast Exams Monthly
American Cancer Society advises all women 20 and older to conduct monthly self-breast exams if they feel comfortable doing so. Self-exams may not always detect major lumps, but they can train you to look for any unusual changes in the look and feel of your breasts, which you should report to your health care provider right away.