Mammograms still imperfect

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Boy, did we hear it from our readers after asserting yesterday that routine annual mammography was overrated, citing a study that found false positive test results can wreak havoc with a woman s psyche.

This reminds me of the bad old days when it was customary for physicians not to tell patients their blood pressure because patients might become anxious or misinterpret the results, commented one reader, AuntieS. Come on; don t overprotect and patronize us women!

Carolina Mom wrote: Anxiety ¦. I had 5 months of chemo, 4 surgeries and 6 weeks of radiation ¦ all because of FALSE NEGATIVE mammograms ¦ I have dense breast tissue and was never told until after my breast cancer diagnosis. My oncologist said my breast cancer was there for at least 3 years. The mass was over 4 inches long and was missed on my regular mammograms. So much for anxiety !

Ron Schmidt said someone close to him also suffered from false negative mammograms Two years later, she experienced pain in her left lymph nodes where the cancer had spread from that presumed negative tissue on her right side. She now faces aggressive chemo followed by other treatments. ¦ I think erring on the side of caution with frequent mammograms (with immediate followup) is better than trying to give a false sense of security based upon some trendy clinical study which may not have scientific statistical significance.

Another reader who left the name, Stage 4 BC @ 54, wrote that While my bc was not detected by a mammograms because I neglected to have them annually, I am paying for it now. ANYTHING that can help catch the disease early where it does not become life threatening is a good thing. I would trade the extra anxiety for false negatives for the current anxiety of having Stage 4 bc at age 54.

ACSH s Dr. Gilbert Ross responds thusly: False negatives are a real tragedy, of course. Humans, even mammogram readers, are flawed and do miss cancers. That has nothing to do with the topic, however, which I can summarize: The more screening, the more findings; the less focus on actual risk factors, the more such findings are likely to be harmful false positives. As for dense breasts, it s only in the past couple of years that highly dense breasts have been determined to have a double-whammy: that quality increases risk of cancer, and also helps to shield it from routine mammographic detection. Nothing about our discussion yesterday indicated that doctors should protect women s delicate psyches as in the bad old days of paternalism. But the pendulum has swung too far in the other direction: Too many tests, too many probably nothing, but we have to do more tests causing vast amounts of needless anxiety. If something is wrong, the patient man woman whoever deserves the facts, I think we all agree on that.