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Should I have a mammogram before age 50?
| This question has been contemplated for years and still there is controversy over the issue. Most recently a study that was reported in the press indicated that there was no advantage to have a mammogram until age 50. While a large study like this holds some weight, it still leaves many questions unanswered. |
December 28, 2006
Oftentimes, the main issues surrounding mammograms are cost and overall benefit. In other words, what is the cost associated with detecting a cancer, and how do survival rates compare to women who do not have mammograms?
Of course, others question the number of benign findings that can occur on a mammogram that lead to a biopsy or other invasive procedure. Some even raise concern about the accumulated level of radiation and use that as a reason to delay.
To begin, lets look at the personal and human issues. Clearly a woman at high risk should start getting regular mammograms in her twenties. But what about women with slightly elevated risks? In my opinion, this is an important conversation for women to have with their physicians. If nothing else, a negative mammogram provides a great deal of comfort since breast cancer is a known cause of worry for women.
In regards to concerns over radiation exposure, its important to know that the level of radiation is quite small and, thanks to new technology, is getting lower each year.
After my many years as a breast surgeon, I am a firm believer in annual mammograms beginning in the forties. It is safe and provides much comfort. It has always been difficult to justify a delay when there are a significant number of women who have mammographically detected cancers before their 50th birthday. How could you explain the cost-benefit ratio to such a woman? And how do you justify withholding a mammogram in this age group knowing that many women do develop breast cancer before this magical age of 50?
