Mammogram Screenings Matter
Recent studies have questioned whether mammogram screenings are causing over-diagnosis and treatment of breast cancer. We talked with Erika Rager, MD, MPH, breast surgeon with Franciscan Physician Network Breast Specialists Indianapolis, to shed light on the issue.
Q: Do Mammogram Screenings Lead to Unnecessary Treatment for Breast Cancer?
A: There is certainly some concern, especially with ductal carcinoma in situ, which is stage zero cancer. It is almost always detected just on a mammography screening. It's a disease process that isn't well understood, but we know it rarely makes masses or causes other changes in the breast.
One issue is, we tend to talk about breast cancer as if it's one disease. But, that's not the case. Instead, breast cancer is a spectrum of varying diseases that have distinct behaviors and require different treatments. For example, we know that all stage zero breast cancer does not behave the same. Some stage zero breast cancers may never turn into a clinically meaningful cancer, while others can turn into invasive cancers that can later spread and become life-threatening.
What we have yet to understand is which cancer is okay to leave alone and which needs treatment. So, we are stuck in a position where we treat breast cancers all the same. We would hate to miss a cancer that turns into an invasive type if we ignore it.
Q: What is Stage Zero Breast Cancer?
A: Stage zero means that we have found cancer cells contained within the milk ducts of the breast. At this stage the cancer doesn’t have the ability to spread into the surrounding tissue.
Q: What are the Benefits of Detecting Breast Cancer with Mammograms?
A: In general, with early detection the tumor is smaller. As a result, it's less likely to have spread to the lymph nodes and the rest of the body. The patient is more likely to have a smaller surgery and more likely to avoid chemotherapy.
Q: Should Women Get an Annual Mammogram Screening?
A: A woman should get a mammogram every year or two. She can get her doctor's recommendation about when to start mammogram screening and how often to get screened. Factors can include personal history, family history, risk factors and her worry level.
As a whole, women who regularly get a mammogram screening are less likely to die from breast cancer. I think the bottom line is that mammograms are still helpful.