The XX Factor

Too Many Mammograms?

The Los Angeles Times has a story about yet another study raising questions about the efficacy of mammograms. As Charles Krauthammer noted in his recent column on the health care debate, Obama is pushing the idea that prevention and early detection will save us billions. But the mass testing of people for all sorts of diseases racks up enormous costs-not just because of the testing, but because of the treatment of symptoms and signs that turn out to be meaningless, and because of the imperative to “cure” diseases that may never have progressed. (The PSA test for prostate cancer is one such example.) The LAT article notes that the new theory of breast cancer is that many cancers found by the X -rays would actually just sit there minding their own business, and some would actually disapear on their own. These constitute a whopping one-third of breast cancers, according to a British Medical Journal study. ( DoubleX ers, how widely known is it that some breast cancers cure themselves? I would say not known at all.)

The problem is that medicine cannot distinquish the deadly ones from the harmless ones, so almost all women found to have breast cancer get some combination of surgery, radiation, and chemo. The study concludes that for every woman whose deadly breast cancer was cured, 10 women with non-progressive disease endure this awful treatment. To me, one of the most notable parts of the article is that in Europe, mammagrams start at 50 and are recommended every two or three years. In the United States, women are told to get one annually starting at 40. That sounds like a lot of unnecessary radiation, which surely must carry its own risk, which the piece does not address. Following the European guidelines, I would have had only one mammogram in my life, instead of the 8-10 I’ve had-and practically every time I go, the technician has had to redo one side or another for technical reasons, so I’m being double-dosed. Obviously we need to put a lot more money into research into distinguishing diseases we need to treat from those we don’t. In the meantime, we could find some of that research money by adopting the European mammogram schedule (and can’t you just hear the radiologists screaming about that?).

Photograph of mammography image by Andreas Rentz/Getty Images.