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Mammogram

A mammogram is still the best way to detect breast cancer in its early stages. Every woman over 40 should get a mammogram every year.

The mammogram is the best way to find breast cancers in their early stages when the chances of surgical cure are extraordinarily high.

Every women over age 40 should not only examine her breasts monthly, but should also have a mammographic examination every year. When a mammogram is done, the radiologist is looking for tiny "stone-like" growths or an irregular lump. No other routine procedure can detect a breast cancer at such an early stage. If a lump or a tumor is found by a mammogram, but cannot be felt, and then it is removed, the cure rate is well over 90 percent and is much higher than the cure rate if you wait until you can feel the tumor. So, it is best to detect the cancer at its earliest stages by mammography, next best to find it by feeling the lump when it is still small, and the worst is not to detect the lump until it is quite large.

Is the mammogram virtually infallible? The answer is no. About 10 to 20 percent of breast cancers are missed by mammography. Some are felt and the mammogram still does not pick them up. Others appear in the one-year interval between mammograms.

If a growth is found, is it always cancer? Assuming the mammogram is interpreted competently, 70 to 80 percent of masses that look like cancer are cancer, but 20 to 30 percent are not. If all lumps found on the mammography (those that look like cancer, those that are somewhat suspicious, and those that look benign) are added together, then only about 20 percent of all growths found by mammography turn out to be cancer.

The major debate about mammograms is what age to start and how frequently to perform them. Healthful Life recommends a mammogram annually starting at age 40. That recommendation reflects the current general consensus. Some experts are unconvinced that mammograms save lives for women under age 50; they urge starting at age 50. Others recommend the mammogram, but suggest that every two years is as good as yearly. Healthful Life believes the evidence is strong enough to recommend starting at age 40, and we recommend a yearly mammogram because of evidence that up to 30 percent of cancers can be missed by a two-year interval between mammograms - so we do the test annually.