Screening Mammogram

We usually do not perform mammograms on patients who have had bilateral mastectomies with reconstruction. Since mammography requires that we compress the breast tissue there would be nothing to compress, as there is no breast tissue. We do not compress implants, even in patients who have them for cosmetic reasons. We usually do not perform mammograms on patients who have had bilateral mastectomies with reconstruction. Since mammography requires that we compress the breast tissue there would be nothing to compress, as there is no breast tissue. We do not compress implants, even in patients who have them for cosmetic reasons.

All of these points are well taken. Recently, I've been thinking much more about the specific mortality benefit of screening (as opposed to diagnostic) mammograms, and I feel pretty disheartened about it. According to clinical trials screening mammograms do save some lives, somewhere between 10% and 30% depending upon the studies. This suggests that current technologies are not sufficient for the majority of women. Clearly, it's something but as you have each pointed out, screening is just not there yet.

When you consider the Papanicolaou (Pap) smear, which has been called “the best screening tool ever introduced for any cancer,” it not only reduces the incidence of cervical cancer by 90 percent by detecting pre-cancerous conditions but has led to a 70% reduction in mortality in developed countries. An article in the American Journal of Clinical Oncology reported that among women who are screened regularly, the Pap smear may have reduced cervical cancer mortality by as much as 99 percent. Screening mammograms have a long way to go before they will result in anything close to this level of success, but is there any reason to keep the bar low? I wonder what the barriers really are to improving this technology.

In the meantime some women are overtreated, others have cancers that do not show up on the screens, and mass screening fails those whose lives are not saved. It's a thorny situation, and I agree that the balancing act between overtreating and saving lives is not one to be taken lightly. I also think the public has a right to know the real limitations to current technologies in ways that enable people to make meaningful decisions.

TAH asked me include a link to "Mammogram Mania" (http://gaylesulik.com/?p=9550), which looks at the mortality benefit across studies and suggests that much of the hype around screening in advertisements and campaigns is hiding some very important truths about the risks, benefits, and limitations of a one-size-fits-all approach to screening. I'd like to answer this from a different approach. Mamograms save lives and the quality of lives (i.e. caught earlier, less surgery, less toxic treatments). My mother was diagnosed in 95, but it was not a mamo that found her cancer...by time it was found the cancer was not in her breast, it was in her nodes (no breast surgery was done, details uncertain). However, two of her four daughters felt that mamos were not worth the risk. It was not until I was diagnosed with early stage that they could fully apprecitate the benefits of mamogram, as it was mamo that found my cancer. Yes, I do understand and fear radiation, however, the cost is too great to pass up on screening. I am excited that thermography is becoming more widely recognized....hopefully in the future this will be an option for all. Please, I urge you...get screened.

more...Yes, I agree with both of you. I am not certain that early detection always saves lives, and I am sure that in many cases, the body might have been able to elimate the cancer cells naturally, without intervention. So yes, the debate goes on....and coming from a person who often refuses dental x-rays, I look forward to the day that prevention and "cures" do not increase our risk for disease. One thing I will say in support of early detection is that often the remedy does not require toxic chemo and damaging radiation, and the misery and damage that goes along with them. In the meantime, I hope we can guide women to make the best possible choices for prevention and detection.

When implants are placed for breast enhancement, mammograms are still performed as drbreastsurgery noted above. However if a mastectomy with implant reconstruction is performed, mammograms generally are not performed. MRI examinations are sometimes done in this situation to make sure there is no recurrence of cancer on the chest wall or muscle, and to check the implants (if they are silicone) to ensure that there is no leakage. it shouldn't make it more difficult, as mammograms can be performed well with implants. the techs have techniques to move the implants slightly, to allow the breast tissue to undergo mammography.

Screening mammograms check for lumps in the breast when there no signs or symptoms of breast cancer. Two X-rays are taken of each breast to determine if there have been any tissue changes compared to previous mammograms and look for tumors and microcalcifications.

Diagnostic mammograms are used to help diagnose or rule out breast cancer. Diagnostic mammograms are given after a lump or other sign or symptom of the breast cancer has been found. For diagnostic mammograms, more x-rays are taken to obtain views of the breast from several angles. Suspicious areas may be magnified to produce a detailed picture. The purpose is to locate and analyze potentially cancerous tumors or cells. Screening mammograms check for lumps in the breast when there no signs or symptoms of breast cancer. Two X-rays are taken of each breast to determine if there have been any tissue changes compared to previous mammograms and look for tumors and microcalcifications.

Diagnostic mammograms are used to help diagnose or rule out breast cancer. Diagnostic mammograms are given after a lump or other sign or symptom of the breast cancer has been found. For diagnostic mammograms, more x-rays are taken to obtain views of the breast from several angles. Suspicious areas may be magnified to produce a detailed picture. The purpose is to locate and analyze potentially cancerous tumors or cells.