Even during a pandemic, paying attention to your breast health is vitally important.
More than a third of American adults have skipped scheduled cancer screenings during the pandemic, and weekly diagnoses fell by nearly 50% for the top six types of cancer during the early months of COVID. Now, as COVID cases decline to get back on schedule with your cancer screenings is important. As a women’s health provider, I often get asked about breast cancer screening. Luckily, there is more scientific evidence related to screening tests for breast cancer than for any other cancer.
Here is what we know:
- When screening women between the ages of 40 to 60 we reduce the chance of a woman dying of breast cancer by 15-20 percent.
- As we become more effective at treating breast cancer, the need for early diagnosis may go away. Meaning, even if we catch your breast cancer later, we have effective treatments that will prevent you from dying from cancer.
- The effectiveness of Clinical Breast Exams (that done by a doctor) and Self Breast Exams (done by the patient themselves) is difficult to determine. This doesn’t mean you shouldn’t perform these exams, it means we don’t know how useful they are.
- The most important harm caused by having mammography is something called a false positive. Meaning, the mammogram shows something abnormal, but it is NOT cancer. One in 10 women will require an additional evaluation (more imaging or a biopsy), but more than 90 percent of the time those lesions turn out to be benign (not cancer). So, don’t panic when you get a callback.
- The second harm that can be caused is something called overdiagnosis. Meaning, we diagnose cancer that was going to resolve on its own and we end up treating it. This happens approximately 19 percent of the time.
- Thermography, though safe, has not demonstrated efficacy. Studies done in the 70’s when this modality was being introduced show a false positive rate of 25% and a false negative rate of more than 60%. Meaning, 60 percent of the time a cancer will be missed. In conjunction with mammograms or breast ultrasound this modality can detect cancer, but by itself it is not enough.
- Breast ultrasounds are being investigated as a way of screening women with increased breast density. The benefit of ultrasound is that it does not expose you to any radiation.
- There is a risk of radiation causing cancer. It is estimated that annual screening over a lifetime will lead to radiation-induced cancer in 16 per 100,000 women. As mammogram machines modernize and emit less and less radiation, this number is falling. Even at this risk, there is still a net benefit to getting a mammogram.
As you can see, like anything in life there are risks and benefits. No discussion of breast health would be complete without mentioning way to reduce your risk of cancer. Exercise, smoking cessation, and decreasing alcohol intake can all reduce your risks. Supplements such as Vitamin D, Selenium, DIM, and Iodine have all been shown to benefit breast health.
Breast cancer screening should start at age 40, and you do not need an order from a doctor to have a screening mammogram. Simply make an appointment with a radiologist.
Hoping you are all safe and healthy during these trying times, I hope this article has shed some light on a controversial subject.
