Mammography Doesn’t Save Lives

Preventive care doesn’t save money and now it turns out mammograms don’t even save lives. After sitting through a presentation by a general surgeon about treatment of small breast cancers (the vast majority of his patients do great), I was stunned to hear him opine, “Every woman needs a mammogram every year starting at age 40.” Really. That’s what he said. I’ve had my doubts. I’ve diagnosed women with breast cancers less than a year after their last mammogram because the tumors grew so damn quickly. Mammography didn’t save them. Now we have new research (linked above) looking at 16 million women (a pretty decent sample size by any reckoning) showing that the more you screen, the more cancers you find WITH NO DIFFERENCE IN HOW MANY WOMEN DIE of their disease. To put it into the vernacular, overdiagnosis is a thing. A real thing, with real drawbacks. Time; money; pain; anxiety. I steamed when the surgeon mentioned above responded to my concerns with the definitive statement, “There is no downside to mammography.” Wrong in so many ways. Ah, but what to do about it? Especially with the juggernaut already running full speed ahead, fueled by millions of pink ribbons and tacky tee shirts. It’s now a performance measure. Women without mammograms are costing me money. So far I’ve been able to take a deep breath and ignore the increasingly strident calls from various insurance companies crying, “Screen!...
Source: Musings of a Dinosaur - Category: Primary Care Authors: Tags: Medical Source Type: blogs