Mammography News: You Heard It Here First … and It’s Still an Outrage!
November 17, 2009
Many women turned on the TV last night, or opened their newspapers this morning and were shocked to find out that a leading independent group of medical experts have determined that women in their forties should not rely on mammography screening to save their lives. This message is a dramatic contrast to the advice most women in the U.S. have been hearing for the last 16 years, but it’s no surprise at all to NWHN members, who’ve had the benefit of reading our information and analysis about this issue for many years.
Mammography screening just doesn’t work very well in women before menopause. Everyone, including NWHN, 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 forties (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.
For more background on the studies and NWHN’s work on this issue, see our Mammography Position Paper.
So what’s NWHN’s reaction to the recent announcement from the U.S. Preventive Services Task Force? We’re glad that the USPSTF has done what they’re supposed to do. They’ve told the truth about what studies have found, and 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 and we’re glad more women now have access to good information.
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 need to find something better.
Women need the equivalent of a Pap smear for breast cancer screening. Pap smears are far fromperfect, but the technology works equally well in 18 year olds and 68 year old. Way back in 1993, the NWHN called for something better. We wanted screening that didn’t use radiation, didn’t hurt, was easy to administer and didn’t have too many false positives.
How far have we gotten since 1993, when we first issued that call? 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 society ignores women’s need for screening that works at all ages it’s African American women who get hurt most.
If this situation makes you as angry as it makes me. I encourage you to do what I do--support the groups that aren’t afraid of the painful truth, and who use that truth to advocate for what women need. As The New York Times reported this morning “Other advocacy groups, like the National Breast Cancer Coalition, Breast Cancer Action, and the National Women’s Health Network, welcomed the new guidelines.”
It’s an outrage that we still have to fight for screening that truly meets the needs of women, but we’re not giving up.