However, one commenter notes:
How about a discussion of the ethics of this particular screening method since it’s fairly equivocal whether it’s actually worth the hassle and all the false positives in women aged 40?
I don’t follow cancer diagnostics enough to be able to comment with any authority on that, so I’d be interested in hearing more from people out there with expertise in that area. However, a 2007 review and meta-analysis says this:
Meta-analyses of randomized, controlled trials demonstrate a 7% to 23% reduction in breast cancer mortality rates with screening mammography in women 40 to 49 years of age. Screening mammography is associated with an increased risk for mastectomy but a decreased risk for adjuvant chemotherapy and hormone therapy. The risk for death due to breast cancer from the radiation exposure involved in mammography screening is small and is outweighed by a reduction in breast cancer mortality rates from early detection. Rates of false-positive results are high (20% to 56% after 10 mammograms), but false-positive results have little effect on psychological health or subsequent mammography adherence. Although many women report pain at the time of the mammography, few see pain as a deterrent to future screening. Evidence about the effect of negative screening mammography on psychological well-being or the subsequent clinical presentation of breast cancer is insufficient.
Personally, I’d rather have to deal with a false positive than wait for a mammogram, but ideally the patient would be presented with the pros and cons of the screening procedure so they know what they’re getting into. For me, the decrease in death rate justifies the potential false alarm, but others may be more freaked out than I am about a potentially positive result.
[Edited to add] And just as I publish this, Janet steps in with a follow-up post on the pros and cons of mammography for breast cancer screening in her age group (under 50). Go check hers out for more of the nuances…