Mammography: Mammograms to detect breast cancer

Mammography

A mammogram is an X-ray used to produce an image of the breast. It can detect abnormalities up to two years earlier than a physical breast examination either by a woman herself or by her health professional. That’s why women over a certain age are offered regular mammograms in many countries. But arguments rage over what that “certain age” should be. Some say 40, some say late 40s, some say 50. There’s another school of thought which advocates the abandonment of mammography altogether on the grounds that it can cause as well as detect cancer.


The risk of breast cancer is far greater in post-menopausal women and the average age for starting the menopause is around 50. If you have other high risk factors, such as a family history of breast cancer, you may be offered regular mammograms even though you are well below the age for routine screening.

Some studies have shown that routine mammograms can reduce a woman’s chances of dying from breast cancer by up to 44%. So you might think all women, regardless of age should be offered this type of screening. The fact is that tumours are harder to detect by mammography in pre-menopausal women, misdiagnosis is more common and the chances of younger women having breast cancer in the first place are slim. And if governments can’t be convinced there’s a cast iron case for widening the screening net then there’s no way they are going to increase the finding for such a programme.

Similarly, in most developed countries women over the age of 69 are not offered routine mammograms simply because the cost of screening older women can’t be justified. Many older women may have other chronic conditions which are a greater threat to their lives or which make any form of aggressive cancer treatment out of the question.

Some campaigners believe mammograms can do more harm than good, especially in pre-menopausal women. Public health crusader Dr Samuel Epstein, a professor at the University of Illinois, has been under constant attack from the cancer industry for voicing widespread concern that routinely exposing hundreds of thousands of healthy women to high levels of radiation is both dangerous and unethical.

Dr Epstein and other medical researchers believe women should be warned that radiation to highly sensitive breast tissue can actually cause cancer. And the flattening of the breast during a mammogram may cause a latent cancerous tumour to rupture and spread to other parts of the body.

These concerns have been raised by respected medics and research scientists on both sides of the Atlantic so it seems much more thorough research is needed into the use of mammography as a mass screening tool.

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