Brenda got the call every woman dreads: “There is an area of concern on your mammogram and we need to take a closer look.”

Fortunately, most abnormalities on screening mammograms are false alarms. More than half of women who undergo annual screening for 10 years will have at least one false positive result. Radiologists would rather err on the side of caution than to miss tumors. Unfortunately, the false alarms can have detrimental unintended consequences. Many women who get the call-back experience days or weeks of panic and fear: of death, disfigurement from surgery, and suffering from radiation and chemotherapy. Others, mostly those with dense breasts, tire of getting called back so many times that they give up on mammograms altogether, a result demonstrated by a recent very large study.

Your risk of a false positive test is higher than average if you: undergo screening every year instead of every other year; have dense breasts; are under 50; take hormone replacement; have had a breast biopsy; or have a family history of breast cancer. This is problematic because some organizations are recommending women undergo screening earlier in life and repeat it annually.

Unfortunately for Brenda, she was in fact found to have cancer. When she first came to the office for assistance, I asked how long it had been since her previous mammogram. It had only been a year, and it was normal at that time, other than her usual “heterogeneously dense breasts.” Looking at the x-rays that picked up the tumor and the films from the previous year, it was obvious that the tumor was not new. It stuck out like a sore thumb. Granted, I had the advantage of hindsight, as well as the more recent films for comparison.

This illustrates another significant problem with the technology we have all come to depend so heavily upon for breast cancer screening: In addition to its high false positive rate, it has an elevated false negative rate in women with dense breasts. This is because tumors have the same density as fibroglandular tissue, which is present in varying degrees in greater than half the female population.

For this reason, 40 states already require providers of mammograms to inform women when they have dense breasts. This enables these women to consider alternative means of screening for abnormalities, including thermography, ultrasound, and MRI. Even the FDA is now on board with the decades-old science and made notification of all women a requirement effective September 10 of this year. This is a late but nonetheless huge step in the right direction.

Fortunately, you don’t need a mammogram to tell you that you have dense breasts. Any well-trained physician can tell you as much during your annual examination simply by identifying the presence of fibrocysts in your breasts. If this is the case, you might consider sparing yourself the unnecessary radiation and talking to your doctor about undergoing other means of early cancer detection.

Taking this a step further, if I was a woman, I would want to know about the study published in 2011 in the journal Radiology entitled “Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades.” In this study, 519 women had to undergo screening mammograms for 7 years to prevent 1 death from breast cancer. A separate study published in the New England Journal of Medicine in 2010 found that 2,500 women had to undergo annual mammography for 10 years to prevent 1 breast cancer death. And a 2014 Canadian study of 90,000 women followed for 25 years found that the death rate from breast cancer was the same whether a woman underwent annual mammography or saw her doctor for an annual breast exam.

Regardless of the exact number, the bottom line is that it takes a lot of mammograms to save one life, and an annual breast exam by a competent doctor is just as effective at preventing breast cancer death as an annual x-ray. The evidence is so strong that in 2015, Dr. Eric Topol of the Scripps Institute announced, “All of the data now available point to significant net harm – far more risk than benefit – for routine mammography. If this were a drug, the US Food & Drug Administration (FDA) would never approve it. Last year, the Swiss Medical Board, after reviewing all the data, recommended abolishing mammography.”

All of this is not to say that mammography is not a valuable tool. It merely demonstrates that it should be reserved for diagnosis—when examination or another screening method identifies an abnormality—instead of being used indiscriminately for screening of women without any concerns. The problem we currently face is that the practice of medicine remains, on average, 17 years behind the science of medicine, according to the Institute of Medicine. Part of this stems from doctors simply not having the time to read and evaluate published medical studies. Another part stems from human nature: Like everyone else, doctors don’t like to discover we were wrong, so we doggedly cling to what we were taught before new evidence came out. We have all heard the slogan “Mammograms Save Lives” so many times over so many decades that it can’t possibly be wrong, no matter what the evidence shows.

If you choose to follow the science and forego annual screening mammography, however, you might be inclined to panic. Even though far more women die of heart disease, for some reason most women perceive their risk of dying from breast cancer to be their biggest health threat. Fortunately, you are not without options. In addition to annual breast exam, you and your doctor may consider other modalities—such as thermography, ultrasound, MRI, or liquid biopsy—as part of a personalized strategy that makes the most sense for your circumstances.

To be sure, no single tool will pick up every tumor. This is why it is important to utilize tools in combination. Moreover, because tumors are not large enough to be detectable by mammography, ultrasound, or MRI until they have been growing for a minimum of 8-10 years, an ideal breast health plan focuses on preventing, reducing, or even eliminating as many of the known contributors to breast cancer as possible. Scientists have uncovered much in terms of the drivers of breast cancer, but the overwhelming majority of physicians in practice have never even heard of most of them. This is why doctors settle for “early detection” instead of trying to prevent breast cancer. But finding a tumor after 10 years of growth can hardly be called early detection, unless we redefine “early” as “before a woman would discover it herself.” However, as noted above, your risk of death is no greater if your tumor is discovered on exam than by mammogram.

When it comes to screening for breast cancer—or any cancer—there are no easy answers. Doctors who make sweeping Fauci-like one-size-fits-all recommendations lose credibility when the actual science proves them wrong. In the absence of clear-cut data, doctors need to use what data we do have to help women make screening decisions that make the most sense for their individual circumstances. Like many women today, Brenda did not have to catch her cancer so late that her breast had to be removed…and neither do you. If you are looking for a more proactive and customized approach and value being in charge of your own breasts, go to www.prestigewellnessinstitute.com to schedule a consultation.

Breast cancer is one of the most well-known types of cancer, but there are still many surprising facts that remain lesser-known to the public. 

1. Men Can Get Breast Cancer Too
While breast cancer is predominantly a women’s health issue, men can also develop the disease. Although rare, about 1% of all breast cancer cases occur in men. It’s important for men to be aware of any unusual changes in their chest area and seek medical advice if necessary.

2. Breast Cancer Isn’t Just One Disease
Breast cancer is not a single disease but a group of diseases, each with its own characteristics and behaviors. There are several subtypes of breast cancer, such as hormone receptor-positive, HER2-positive, and triple-negative breast cancer. Each subtype has unique features and may require different treatment approaches. Understanding these subtypes can help patients and their families make informed decisions about their treatment.

3. Genetics Play a Role, But Not the Only Role
While BRCA1 and BRCA2 gene mutations are well-known risk factors for breast cancer, they account for only about 5-10% of all cases. Most women diagnosed with breast cancer have no family history of the disease, underscoring the importance of regular screenings for everyone.

4. Dense Breast Tissue Increases Risk
Women with dense breast tissue have a higher risk of developing breast cancer. Dense tissue can also make it harder to detect cancer on mammograms, which is why additional imaging tests, such as ultrasound or MRI, might be recommended for these women. 5. Lifestyle Choices Matter Certain lifestyle factors can influence breast cancer risk. For example, engaging in regular physical activity, maintaining a healthy weight, limiting alcohol consumption, and avoiding tobacco can all help reduce your risk. A diet rich in fruits, vegetables, and whole grains is also beneficial. These lifestyle choices can help maintain a healthy body weight, reduce inflammation, and regulate hormone levels, all of which can contribute to a lower risk of breast cancer.

6. Breast Cancer Can Affect Young Women
Although the risk of breast cancer increases with age, young women can and do get breast cancer. About 11% of all new cases in the U.S. occur in women under 45. Young women should know their bodies, perform regular self-examinations, and report any unusual changes to their healthcare provider. Early detection through self-examinations can significantly improve the chances of successful treatment.

7. Survivorship is Increasing
Thanks to advances in detection and treatment, breast cancer survival rates have been steadily improving. The fact that there are now more than 3.8 million breast cancer survivors in the United States alone is a testament to the progress made in the fight against this disease.

Prevention is Key
Regular check-ups with your healthcare provider are crucial for early detection and prevention. Early detection is critical for the successful treatment of breast cancer. Regular mammogram screenings are essential for catching cancer early when it is most treatable. At Moab Regional Hospital, we offer state-of-the-art imaging technology to ensure the highest quality care for our patients. Schedule your yearly mammogram today and take a proactive step towards protecting your health.

Remember, knowledge is power, and early detection can save lives. By staying informed and getting regular screenings, you can take proactive steps to protect your health and increase your chances of successful treatment. There is hope in early detection; taking action can make a difference in your health and well-being.

Moab Regional Hospital is here to help with advanced 3-D mammography, using the latest technology to check for breast cancer and other concerns. If you’re a woman 40 or older, remember to schedule your yearly mammogram screening to catch any early signs of breast cancer. Call 435-719-3690 to make an appointment.