By Jacob Molyneux, senior editor/blog editor
Diana Mason, AJN‘s emeritus editor-in-chief, posted here on the new U.S. Preventive Services Task Force mammography recommendations earlier this week, noting some troubling questions AJN had raised years ago about how much evidence actually supports the wholesale acceptance of yearly screening for women age 40 and older.
But we know that the bottom line for many American women remains this: “Are you really telling me that it’s better not to know as early as possible that I might have cancer? You must be kidding!” After all, we’ve all heard of someone whose life may have been saved by the early detection provided by a mammogram or a breast self-exam.
What about the other side of the experiential coin? Forget the evidence for a minute. Let’s not talk about the fact that, as Maryann Napoli pointed out in AJN in 2004, the “technology leads to the unnecessary treatment of some cancers that might have remained latent, and it also detects invasive breast cancers so slow-growing that women will have long lives regardless of when tumors are found.” That’s what the science may be telling us. That’s for the number crunchers.
What we want to know is more basic: have you or your patients ever experienced real suffering and anxiety from a false positive result, or negative consequences from treatments that you may now believe to have been unnecessary? Is there really anything to this concern—and will it ever be enough to convince women without significant risk factors for breast cancer that it might actually be better to wait for that mammogram?
(For some illuminating historical perspective on the topic, see the Op-Ed piece in today’s NY Times, Addicted to Mammograms.)