The New York Times recently ran an article by an author who was questioning whether breast-cancer screenings save lives (and breasts). When I heard about this article, I felt quite distressed, fearing that a statement such as this would set us back rather than move us forward in getting more women diagnosed with early-stage breast cancer.
Prior to the widespread availability of mammography, women either had to rely on a doctor to find a lump or they had to find it themselves and then come in for diagnosis. Overwhelming evidence has now shown that mammograms reveal cancers far earlier than can the older hit-or-miss methods.
Finding cancers before they've become big enough to detect by hand allows us to catch them at a stage when they're far easier to treat and are much less deadly. So don't tell me that mammograms haven't saved the lives (and breasts!) of great numbers of women.
The Times article, which raised questions about the value of early detection, focused on whether breast-cancer screenings truly save lives and reduce mortality. The author even made the rather embarrassingly self-evident observation that, even if a cancer is detected later rather than sooner and has grown larger and more severe in the meantime, the patient still might survive the disease and its treatment.
Well, yes, that's certainly true. But no doctor can predict ahead of time whether a breast cancer you might get at some future time will spread to other organs and take your life. If a woman is alerted by a mammogram that she has a small (4 millimeters across), invasive tumor that seems to have favorable prognostic factors, then she can probably be cautiously optimistic.
But if that woman never gets a mammogram and instead finds the lump herself later on--after it has ballooned to 2 centimeters (10 times its earlier size)--then we would have no way of knowing whether she is going to survive her diagnosis and treatment. All bets are off.
And as long as we have no way of gauging a tumor's outcome except by means of mammography and surgical removal to determine its true size and prognostic factors, we're going to need pathologists and mammography machines and radiologists to tell us who is going to be diagnosed, and when, and what her survival opportunity from the disease will be. And of course none of that can be accomplished without the needed information from surgery or other treatment having taken place.
In other words, my message to you is always going to be this: Please get your annual screening mammogram. And don't you dare let this latest bit of chatter from the media give you any doubts about the value of early detection.
