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Mammogram recommendations cause confusion

October 20, 2010 12:00:00 AM PDT
We've always heard yearly mammograms starting at age 40 equal early detection. But recent studies focused on how annual exams led to false positives, unnecessary biopsies and missed cancers. But many doctors and patients say don't let all the controversy confuse you.Mattie Singer, 42, gets a mammogram every year, but a mammogram didn't catch her breast cancer, she did.

"What made me suspicious that something was wrong was that I had some swelling under my arm," said Singer. "It turned out that it had already spread to my lymph nodes."

Missed tumors and unnecessary follow-up testing in younger women are among the many reasons a government panel advised women to wait until they are 50 to get a mammogram. And then go every other year.

A New England Journal of Medicine study also said the benefits of mammography catch far few cancers than earlier thought.

But a new, large Swedish study conducted on women between the ages of 40 and 49 found yearly mammograms reduced breast cancer deaths 26 percent.

Breast care expert Dr. Deanna Attai says it's no surprise women are confused.

"We're trying to balance between over treatment and saving lives," said Dr. Attai.

Dr. Attai advises women to ask for digital mammograms which are easier to read. She adds testing for known breast cancer genes can help narrow down which women may need additional screening exams such as MRI's.

"It's important to realize that not any one of these tests is perfect, but I think where some of the controversy was actually helpful, is it started more dialogue," said Dr. Attai.

The Swedish study showed for every 1,200 mammograms performed, a life is saved.

OB/GYN Dr. Bryan Jick believes most women would agree it is worth it.

"I hope it's going to become a settled issue that screening mammography should start at age 40 and that screening mammography in that young age range does save lives," said Dr. Jick.

Even though mammography missed her cancer, Singer strongly believes it can save other women from what she's going through.

"I believe that if there is a tool there that can help you catch it early you should do it," said Singer.

Both doctors recommend having a discussion about your personal risk assessment. Once you know this it can help both of you develop a screening strategy.


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