Re: mammograms : When? How often?

The second-most common cancer in women is breast cancer.  According to the Centers for Disease Control, 41,000 women die each year from the disease.

Breast cancer has affected many women in every community in America. Some women have themselves been diagnosed; but even when a relative or friend gets the news, it still can be a very personal experience for everyone involved: spouses, partners, children, parents and friends.

Even for the health-care community, breast cancer can be a very sensitive topic. A recent article in the Journal of the American Medical Association encourages doctors and health-care authorities to rethink cancer screening guidelines, and the U.S. Preventive Services Task Force has actually changed mammography screening recommendations. You may have heard about these changes on television news or in The New York Times.  The outcry from the media, legislators and doctors has been substantial.

It certainly is a good time to take a careful and reasonable look at breast cancer issues.  In this column, I will outline the screening recommendation changes and their reasons.  In following weeks, I will discuss approaches to breast cancer screening, prevention and treatment that make sense from a mainstream medical and  naturopathic perspective.

No one is disputing whether mammography works for detecting early-stage breast cancer; it does. The concern is that all of the suspicious lumps found by mammogram can result in unnecessary biopsies and unnecessary worry; at some point the cost outweighs the benefit.  

According to the best statistical evidence, for women 40 to 49 years of age it takes screening almost 2,000 women to identify one cancer that would be helped by treatment.  For women 50 to 59 years old the number falls dramatically, to about 1,300 women screened to identify one cancer helped by treatment.  For women 60 to 74 years old, the numbers get even lower.

The bottom line is that there are potential benefits and costs to any health-care choice. With the guidance of your physician, you get to choose the approach that makes sense to you;  every woman has different risk factors and concerns.

In my next column, I will discuss prevention and other screening options.

Richard Malik is a naturopathic doctor with a practice in Lakeville offering comprehensive health care for the entire family.