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Dear Dr. Kate, Thoughts on the New Mammogram Policy?

Wed, Aug 4, 2010

Advice, What's Up Doc?

photo by PinkMoose

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here once a week. To ask her your own question, click here.

Dear Dr. Kate,

What do you think of the new mammogram policy?

– Keeping Abreast

Dear K.A.,

I love it.

Unfortunately, medicine and science are great at producing tests and studies that become part of the standard care we receive long before we know if they do any good or not. Mammograms definitely save lives by finding breast cancer before we can feel a lump, but they’re not perfect — and I don’t just mean that they can miss a very small cancer. Mammograms can lead to unnecessary testing and biopsies that all have their own risks. And confusingly, they may pick up what are called indolent cancers — the slow-growing kind that would never kill someone — that then get treated, with all of the side effects that follow. How awful, to treat a cancer that didn’t need to be treated, then the woman has to live with the effects of the chemotherapy and radiation, that may cause additional serious problems.

So we need to balance the benefits and risks of this test, like all others. We need to give mammograms to enough women to save lives, but not give them to so many women that more women are hurt rather than helped by the tests. And that’s what the new guidelines aim to do. If you have a high risk of breast cancer (abnormal biopsy, strong family history), the new rules won’t apply to you. And the guidelines are not a hard-and-fast rule; you and your doctor can work out a testing schedule that feels right to both of you. And for the majority of women, these guidelines may be just right.

– Dr. Kate
Gynotalk

dr_kate_100Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.

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One Response to “Dear Dr. Kate, Thoughts on the New Mammogram Policy?”

  1. elyau Says:

    Multi-modality analyses (ie mammograms + MRI or PEM – go look that one up! It’s gaining some ground and could definitely shake things up) are much more accurate than just a simple mammogram, and can really help avoid unnecessary surgeries. Still not perfect, but the costs of adding more analyses is probably what’s keeping this from becoming a standard procedure.

    There was a recent NYTimes.com article on how sometimes, it’s actually the histologists who goof up after a biopsy is taken. A good rule of thumb is if you feel hesitant about a diagnosis, just go find a second opinion before taking any serious actions.


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