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The Mammography Conundrum

Many of us in the leadership of the breast cancer advocacy movement have been
receiving unfair...and even nasty messages. I have been thinking for 2 days how to
respond and then received Susan's message. She says it best for ALL of us.

"I hear your anger. I’m angry too. But not for the same reason. I’m angry
because we’ve oversold the benefits of mammography to the extent that there is
no longer room to look objectively at the evidence. Let’s work together to examine
the evidence and to advocate for the research funding that will end this disease."
SL

Please click here to read the full text of Dr. Susan Love's reply, as well as up to
date information regarding screenings.

The Rhode Island Breast Cancer Coalition urges you to "open your mind" to fully understand the recommendation
announced Nov. 16th by the United States Preventive Services Task Force on mammography screening.

These guidelines do not apply to women with risk factors for breast cancer. These risk factors include, but are not
limited to, family history of breast cancer, genetic mutation for breast cancer, those with previous suspicious
mammograms and or a history of benign breast biopsies, and those already diagnosed with breast cancer.

The USPSTF analyzed years of scientific data to support a recommendation that will reduce harm from over
screening and over treatment. Unfortunately, due to years of wrong public messaging, women do not think that a
screening test (mammogram) can be harmful. However, a screening mammogram can trigger unnecessary further
tests, like biopsies, that can create extreme anxiety; long term exposure to radiation (which does not leave your
body) can cause breast cancer and, mammograms can find cancers that grow so slowly that they would never be
noticed in a woman's lifetime, resulting in unnecessary treatment. Also unfortunate, is that many women consider
mammography screening to be a preventive for breast cancer.

In order to formulate its guidelines, the USPSTF used new data from mammography studies and commissioned six
groups to make statistical models to analyze the aggregate data. These models were the only way to answer
questions like "how much extra benefit do women get if they are screened every year". The answer from the six
modeling groups was unanimous...."very little"...."so little as to make the harm of additional screening come
screaming to the top", a quote from Dr. Don Berry, a model group leader and statistician from MD Anderson Cancer
Center.

The RIBCC wants women and men to understand that the new guidelines bring the truth about screening to their
attention. Annual screening for breast cancer has been a successful marketing tool for several cancer
organizations, radiology businesses and specific population of physicians.   Annual mammography screening has
never been based on scientific evidence.

Women have been misled by marketing messages before...for example, hormone replacement therapy.

Women are intelligent and capable of asking "show me the evidence" and making an informed decision about
when to have a mammogram.

Are the new mammography screening guidelines difficult to accept? YES, but only because it challenges the status
quo and causes an emotional reaction.

All medical interventions... screening, treatment and prevention... must be based on scientific evidence and
comparative effectiveness.   Assumptions have no place in quality health care.