The latest news out of the breast cancer research world last week felt like a choke-hold, and sounded like a joke.
Making national headlines, a Danish study published Jan. 9 in the Annals of Internal Medicine, and using data recorded from old technology, concluded that 1 in 3 women with breast cancer detected by a mammogram is treated unnecessarily.
The results found that mammograms detected tumors so slow-growing that they are harmless, leading to “overdiagnosis” and “false-positives,” causing women unnecessary treatment such as surgery, chemotherapy and radiation, and do not lower the incidence of advanced stage cancer.
Huh?
Cancer, by definition, is an out-of-control, rogue cell gone very wrong, and multiplies and grows at its own rate. From my own experience, my breast cancer tumor grew to three times its size in one year. It got so large that I felt it growing myself and knew something was wrong.
Two oncologists I consulted after I was diagnosed told me it had been a “slow-growing” tumor that had most likely been in my body for many years. Had it been properly detected earlier on by a more competent OB-GYN, should I have left it alone?
Who knew it was going to explode one fine year, and that by the time I had surgery to remove it, the cancer had already spread outside my breast. I would have welcomed a “false positive” at a much earlier stage and had the tumor removed before it grew and spread. In my case, it was a false-negative, which is much more deadly.
I’d like to say the study conclusions are irresponsible, but I think it goes deeper than that. It is part of the war on women, and women’s health that has become, especially in recent months, more widespread, more acceptable.
Let’s look at the attack on detecting breast cancer:
In 2009 the U.S. Preventive Services Task Force, whose members are appointed by the Department of Health and Human Services, recommended women start mammograms at age 50, get tested every two years, and stop at age 74.
In 2015, new guidelines released by the American Cancer Society recommended that women start getting mammograms at age 45, and then one every other year, a break from the ACS decades-old recommendation of starting at age 40 and continuing annually.
But according to the Agency for Healthcare Research and Quality, since mammograms came into wide use in the 1980s, they have reduced the risk of dying from breast cancer by 25 percent to 31 percent for women ages 40 to 69.
Mammograms are not perfect. Women, who have a 1 in 8 chance of developing breast cancer, are still dying from the disease. In 2015, according to the American Cancer Society, breast cancer killed 40,290 women. Breast cancer is the second leading cause of cancer death in women after lung cancer.
The screening technology can get better, and it is. The newer 3-D mammograms, also known as breast tomosynthesis, came into use about 2011. After articles by the Citizen-Times questioning the absence of the new technology in Asheville, Mission Health first introduced 3-D mammograms in 2014.
Research has shown 3-D mammograms to be more effective than 2-D (also known as digital mammograms) at detecting cancers at earlier stages, especially in women with dense breast tissue. They also produce fewer false-positives.
It is important to note that the Danish study used data collected between 1980 and 2010, before the use of 3-D mammograms.
Tomosynthesis is now available at every major imaging facility in the greater Asheville area, and is expected to soon completely replace the older technology.
Mammograms are the first line of defense in the fight against breast cancer, and are required, under the Affordable Health Act, to be covered by health insurance at no cost. Also under the ACA, or Obamacare, health insurance companies must accept patients with pre-existing conditions, such as cancer.
Now that the ACA is all but unraveled, there is the threat that these rights will be destroyed.
To suggest that we shouldn’t get mammograms, and shouldn’t heed the results because they might cause women undue treatment, is harmful, and scary.
Nobody will force you to have surgery, chemotherapy or radiation. But we need to know what’s going on in our bodies before we make those decisions.
No matter what the results of screening mammograms, 2-D or 3-D, women need to perform breast self-exams, know their risk factors and educate themselves, so that we are prepared to make intelligent decisions about our health care.
The March on Asheville Jan. 21, in solidarity with the Women’s March on Washington, aims to empower women to take back their rights, including their health care rights.
In response to the Danish study, a friend who has lived through breast cancer said: “I think this is truthfully much more about costs and money and not what is best for us. It seems like there is a value on our heads when we should be priceless.”