Sharon Hospital: Mammograms are still essential

SHARON — Women have been getting fewer mammograms and the reasons for the trend are unclear. One reason could be the tough economic times, and an increase in the number of unemployed and either uninsured or underinsured women. To encourage women to take advantage of this preventive diagnostic tool, Sharon Hospital will offer two free, walk-in mammogram days next week.

On Oct. 14 and 15, women who are uninsured or underinsured (eg who have very high deductibles) can get a free mammogram at the hospital. Appointments are not necessary; the program is offered from 4 to 7 p.m. on Thursday and 9 a.m. to 4 p.m. on Friday. The mammograms are offered on a first-come, first-served basis.

Preceding the Oct. 14 event is a lecture at 3 p.m. by Benjamin Seckler, MD, who is the new chief of the hospital’s radiology department. Among other topics, Seckler will talk about a study done in 2009 that discourages women under the age of 50 from having annual or even biennial mammograms.

The study was published last November by the U.S. Preventive Services Task Force, which describes itself as “an independent panel of non-federal experts in prevention and evidence-based medicine.� The task force is made up of doctors in a variety of practices from a variety states including Arizona, Texas and New Hampshire.

The study says that mammograms are most useful for women aged 60 to 69 years. For women over the age of 75, “evidence of the benefits of mammography is lacking.� And for younger women, the study says that mammograms do more harm than good because they can create anxiety in the women or lead them to have biopsies on masses that might turn out to be benign and not cancerous. It also warns that doing mammograms on women can uncover cancers and that this might lead to treatment of cancers that “would not have shortened a woman’s life.�

The study warns, too, that women should not be taught to do breast self exams at home because “there is moderate certainty that the harms outweigh the benefits� (the report does not elaborate on this point) and it says it’s hard to know whether it is worthwhile for doctors to do breast exams: “For clinical breast exams as a supplement to mammography, evidence is lacking and the balance of benefits and harms cannot be determined.�

In his talk on Oct. 14, Seckler will explain why radiologists, oncologists, ob/gyns and the American Cancer Society disagree with the study and feel that women should continue to do breast self exams and have their doctors do a breast exam, and should definitely continue to have regular mammograms after the age of 40.

Breast cancer is the second leading cause of death among American women, according to the Centers for Disease Control in a report on its website about breast cancer screening that was published in July 2010. The article notes that “After mammography was shown to be effective in lowering morbidity and mortality from breast cancer in the early 1990s, it was adopted rapidly for the early detection of breast cancer.�

In recent years, though, the article notes that the numbers of women having mammograms has decreased. “The most common reason women give for not having a mammogram is that no one recommended the test,� according to the article.

Sharon Hospital is strongly recommending the test to all women over 40. Cynics might say that the hospital is looking for ways to increase use of its state-of-the-art equipment, but the offer of free mammograms for women who can’t afford them on their own seems to counter that argument.

Steckler in particular is adamant about the importance of the mammograms.

“Smaller is better when it comes to cancer,� he said in an interview last week. “If you catch it before it spreads to, for example, your lymph nodes, your chances of survival are much better.�

Studies show that the breast cancer mortality rate began to drop as more women got mammograms. Seckler said he fears that, if women stop taking advantage of this diagnostic tool, “10 years from now we’re going to see an increase in breast cancer mortality.�

Another reason listed on the CDC website for women not taking advantage of mammograms is that the technology is not available where they live. “Counties with no mammography units had the lowest mammography utilization.�

Sharon Hospital has “the latest and greatest technology available in the country today,� Seckler said. “Just because this is a cute little hospital in the country, that doesn’t mean you’re not getting top-of-the-line care. This is the equal of any large hospital in the country.�