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Friday, May 3, 2013

Not So Pretty in Pink: Just Say No to Annual Mammograms

For the past 10 years or so on Mother’s Day, I have joined the thousands of people who attend the Susan G. Komen Race for Life in Philadelphia.  I walk in solidarity with my sister-in-law Barb, who fought the disease that many years ago and thank God is cancer free. I enjoy the spectacle and the time we spend together walking through downtown Philly catching up with her my brother John and their kids.

It’s become an enjoyable Mother’s Day tradition for me but not for the cause. While I support cancer charities financially, I don’t register as a runner/walker or contribute to the Komen Foundation. As a PR professional, I admire Komen’s marketing machine. But the pink ribbon advertising campaigns have lost me. (Pink NFL player shoes were my tipping point.)

In the April 28 New York Times Magazine, reporter Peggy Orenstein, who is battling breast cancer (again after her first diagnosis 15 years ago) wrote about the pink PR movement.  (Worth reading, especially if you are a young woman who has never had a mammogram, Stop reading my words and go read this article. It may save you a lot of pain and suffering.)

I was surprised to learn in this article that less than a quarter of the funds Komen has raised over the years went to breast cancer research.  It's not that they aren't spending on the disease, it's more that Komen has decided to promote awareness and early detection of breast cancer through mammography.

Turns out that while this may have been the right idea when they started out so many years ago, it appears that all this screening may not be the answer to beating breast cancer.

For most of my life, doctors recommended women to get a baseline mammogram at age 40 and then return every year as a preventive screening. Now medical research suggests that most women can wait until 50 and every other year is adequate, unless you have a family history or have identified with the breast cancer gene. (This is the accepted protocol in Europe and in other developed countries.)

Over--screening is finding a cysts and other growths that will never become a deadly cancer.  Women are getting unnecessary biopsies, even worse, mastectomies, not to mention the harm from excessive radiation. The number of women who are “saved” by early detection is so small, that it doesn't outweigh the bad medicine.  (Men suffer from a similar finding about too much prostate cancer screening.)

Every year, my doctor writes a script for an annual mammogram. Makes me wonder why they aren't reading the same things I'm reading. My local hospital has been nagging me with reminders since my anniversary date passed in February.  I get it that the hospital has expensive machines to pay off and a staff they want to keep busy. But at what point should health care providers forget about the money they need to run their health care machines and listen to the evidence? 

Medicine is an art as much as a science, but we have a good body of research on this now.  I would love my doctor to give me both sides of the argument and give me the option for a one or two year repeat. I'll sign whatever form he needs to absolve him from a lawsuit.

Even though I am not aligned with the Komen Foundation on this topic, I hope to be on the Parkway this Mother's Day walking with Barb and all those other people who are remembering someone they love who has known breast cancer. You can really feel the love at that event.  

Do conflicting messages about health care make you crazy?  Do you ever dare to tell your doctor that you are not going to have that EKG, mammogram, prostate screening, blood test, etc.? Let us know what you think.


  1. Chris, your post reminds me that years ago when I debated a medical decision a doctor friend quipped, "Why do you think we call it "practicing" medicine?"
    I think doctors at times doctors are as confused as patients about what to do when evidence changes

  2. I fear that doctors worry about malpractice claims and hospitals need the money that insurers will pay for annual mammograms.

  3. Hey, Chris, I get it about the over-screening, but listen to my story. I'm a ten-year survivor. When my tumor showed up on a mammogram, it wasn't much bigger than a pea. We had trouble scheduling the lumpectomy, so it was two months before they operated. By surgery day my tumor had grown to the size of a golf ball. I had DD-size breasts and the lump was back against the chest wall. We could see it on a scan, we knew exactly where and how big it was--and it still could not be felt on a manual exam. I was 55 and if I hadn't had yearly mammograms, I wouldn't be here to write this comment.

  4. Linda, Your response shows me why this is so difficult to decide. It's easy to decide when it's just data, but when you have a person, a name, a real story like yours, it's so much more powerful. You were saved (as was my sister-in-law) but then there are all those other women who are having a test they may not need.

    I don't have the answer, of course. It is a personal decision and we have to live with the outcomes.

    I am so glad you are here and grateful that you shared your story.

  5. Chris,

    Thanks for sharing the article, and your thoughts. I have a healthy skepticism of doctor's advice, based on many misdiagnoses over the years, and as I approach (gulp) 40, I'll have to wade through the opinions on this one. Good food for thought.

  6. Interesting blog post. Thought I'd share some of the updated information and offer some more food for thought.
    Should Mammograms Be Squashed? -
    Be well!
    Dr. David Friedman