Breast Cancer Screening Choices
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Cancer Screening Conundrum

Controversy surrounds new cancer screening guidelines.

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By Jenny Song

Too Scared to Not Get a Mammogram?

Emotions and evidence don’t always align

By Jenny Song


In 10 years, I’ll be 40. And while there’s not much I can tell you about where I’ll be or what I’ll be doing when I hit that major milestone, there’s one thing I know for sure. I want a mammography technologist to push, pull, squeeze, flatten and radiate my breasts. Why? Because breast cancer scares the heck out of me.

MammogramI’m an Asian woman with no history of breast cancer in my family. (At least none that I’m aware of.) I gave birth to my first child when I was 28 and breastfed her for nearly a year. And I am a health care reporter, who knows that all of these factors stack in my favor, lowering my overall risk of developing this disease. But for as long as I can remember, I’ve been conditioned to believe that getting an annual mammogram starting at age 40 is my best bet for keeping me from becoming a breast cancer mortality statistic.

The recommendations released by the U.S. Preventive Services Task Force that caused a fierce backlash from the public last November explained that there is no scientific evidence that annual mammography screening of asymptomatic, low-risk women under age 50 reduces breast cancer mortality. I reviewed everything they had to say closely. Yet, still, I’m torn.

As a reporter who has covered health care for almost eight years, I know that mammography is not a good tool for detecting breast cancer in women under 50 because younger women have dense breasts. I could be told, “All clear,” and still have a tumor growing. What’s even more shocking is that for women in their 40s, the risk of dying of breast cancer is 3.5 out of 1,000 without a mammogram. With a mammogram, that risk only falls to 3 out of 1,000. And let’s not forget to mention the number of needless biopsies millions of women have endured as a result of mammography.

As someone who has had three biopsies of a mouth lesion over the past four years—something that so far has been benign—I know a tiny bit about the physical and psychological pain that comes with a biopsy. Yet for all the cursing and screaming I silently do each time my dentist wants to get another tissue sample from my mouth to confirm I do not have cancer, I find reassurance in the fact that I am being proactive about my health.

And so even though I know that the line between early detection and not dying of breast cancer is not as clear as we once believed it to be, I can’t help but wonder: What if I’m one of the few women for whom mammography might make a difference? This is where my background as a health care reporter crashes with my emotional life.

In 10-year’s time, I don’t know which will win out: my fear, or the voice in my head that tells me to look at the evidence and weigh my actual odds of dying of breast cancer. I’ve been told I need to take my personal medical history into consideration and come to a decision after talking with my doctor. I guess I’ll be calling my doctor when the time comes. But I’m also hoping that between now and then, we’ll have learned enough about breast cancer so that women who, like me, are grappling with these questions will be able to make a fully informed decision and not feel like they’re gambling with their lives.


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(image: © Kings College School of Medicine / Photo Researchers Inc.)