Breast Protection Providence RI

Breast Protection

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By Sally Lehrman

Shortly after I turned 40, my doctor sent me off for a screening mammogram—my first since a lump (benign, fortunately) had appeared two decades earlier. As I entered the floral-wallpapered waiting room, I felt welcomed into a special sorority. Women lounged in comfy chairs, reading magazines, in varying stages of undress. I pulled on a thin gown, and one kind older woman, noticing my goosebumps, advised me to use two, one facing forward and one back, for warmth. When I left, the receptionist handed me a single pink rose.

Like most American women, I went on to take part in the periodic rituals of that peculiar sisterhood, showing up at the clinic once every year or so for my mammogram. Though I had no family history of breast cancer, my doctors and widespread public health messages had convinced me that this regular trek was my best protection against the life-threatening disease.

Apparently many other women feel the same way: In a survey published in 2004, nearly 90 percent of women said they got screening mammograms (those given to healthy women with no sign of the disease), and most felt it would be irresponsible for a midlife woman not to.

But unbeknownst to most of us, specialists passionately disagree on the value of mammographic screening, the current gold standard for finding breast cancer. Indeed, an increasingly vocal group of oncologists and radiologists believe these purportedly lifesaving tests aren’t as helpful as we’ve been led to think, and that they may even do quite a bit of harm, especially in younger women.

“You can only stick your head in the sand for so long,” says Cornelia J. Baines, a public health researcher at the University of Toronto who conducted a major study of mammography. “I think mammograms will be a forgotten technology before long.”

Can she really be talking about screening mammography? The technology that the American Cancer Society, the American Medical Association, and just about any doctor you talk to say gives us our best shot at catching breast cancer before it kills us?

Actually, yes. And Baines is no crackpot. In one study, she and her colleagues followed nearly 90,000 women in their 40s and 50s randomly assigned to get mammography and breast exams or breast exams alone. They found that while screening mammography helped detect more and smaller cancers, it did not reduce death rates at all. Worse yet, in a trend that didn’t reach statistical significance but was still worrisome, women in their 40s had higher death rates from breast cancer when they did get screened.

That sounds like a through-the-looking-glass conclusion, given the way we’re accustomed to thinking about mammography. But when a highly regarded group of health care analysts at the Cochrane Centre in Copenhagen sat down to review the seven biggest and best studies on mammography screening, they concluded that only two were solidly designed—one of which was Baines’s study. The Cochrane group’s conclusion—h...

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