The XX Factor

We Need a Pap Smear for Breast Cancer

Mammography screening just doesn’t work very well in women before menopause, as the U.S. Preventive Services Task Force has now recognized . Everyone hoped that it would. But in 1993, it became clear from well-done studies that our hopes hadn’t panned out, and screening just didn’t work well for women in their 40s (or at all, for even younger women). The fact that most women didn’t know this, and instead received a falsely optimistic message about the life-saving benefits of once-a-year mammography screening, was incredibly frustrating. More background here .

At the National Women’s Health Network, we’re glad that the federally appointed task force has told the truth about what studies have found. Now women have a better chance of getting an honest assessment about the value of a heavily promoted technology. Information is always a good thing.

But I’m not at all happy today. Not even to be proven right about things that I took a lot of criticism for saying. Rather, I’m outraged. We’ve known for 16 years that mammography screening doesn’t work well for women before menopause, and not at all for women under 40. And at the same time, we’ve known that a significant number of breast-cancer cases occur in women under 50. So once we knew mammography wasn’t good enough, the next step was obvious-we needed to find something better.

Women need the equivalent of a pap smear for breast cancer screening. Pap smears are far from perfect, but the technology works equally well in 18-year-olds and 68-year-olds. How far have we gotten on a pap smear equivalent for breast cancer? Not very far at all. And that’s why I’m outraged. A huge amount of money has been spent on breast-cancer research in the last 16 years, but far too little has gone for research into truly new forms of screening. Who suffers as a result? All young women, of course, but African-American women suffer more than everyone else. For some reason that’s not yet fully clear, African-American women are more likely to develop breast cancer before age 40 than are white women. So if we fail to develop a screening that works at all ages, it’s African-American women who get hurt most. Let’s get moving.

Another version of this post appears here .

Photograph of pink ribbon by Photodisc/Getty Creative Images.