Why is Screening for Breast Cancer Important
The impact this disease has, on not only the individual but the people around them, is powerful. Even though the tests show cancer, I am thankful that I had the annual test. It is true that stress, anxiety, and money can be saved by waiting until the age of 50 years old because of misinterpretation and overdiagnosis. However, early detection is the key to success in the battle against breast cancer. There are many different options for detection scans that women can choose. Inconclusive results will cause some women spend more money and endure more stress than necessary because of uncertainty among experts.
The cost of mammograms should not determine whether or not a women goes in for the test. Beginning at the age of 40 years old years old a women can have a greater chance of early detection and a better chance to beat cancer. A women that begins her annual mammogram screenings at the age of 40 years old rather than 50 years old will have more benefits than drawbacks in the long run. When an individual waits until age 50 years old to begin annual mammography screenings they can save themselves from stress, anxiety, and higher medical expenses. Waiting until the age of 50 years old can save a patient from misinterpretation and overdiagnosis that can lead a patient to have excessive amounts of tests and treatment procedures done to them. The US Preventive Services Task Force recommends starting at age 50 years old (Alonso-Zaldivar 2).
According to studies carried out by the Task Force, women ages 40-49 showed more false positives from mammograms (Alonso-Zaldivar 2). Dr. LeFevre states, “When a patient gets a phone call saying a CT scan isn’t normal, 19 out of 20 times it’s not cancer.” (Kotz 2). However, a patient will probably choose to do further testing. This can lead to misinterpretation, overdiagnosis, and the detection of tumors that are not likely to cause harm (Beck 2). Assuming that cells that look like cancer will act like cancer is the medical equivalent of racial profiling, this is not a good thing. If cells appear to look like cancer, further tests should be run just in case. Dr. Esserman declares, “By treating 1000 people who have low-risk disease, we are not going to save the one person with aggressive disease.” (Beck 3). Although waiting until age 50 years old can reduce the chances of over-diagnosis, it can be risky to wait until that late in life to start screenings. This choice should be made by the patient and not a panel of experts.
Today researchers are winning some battles against breast cancer and the earlier detection will only increase the number of battles that are won. Breast Cancer takes the lives of many women each year in America. Breast cancer is the second most common cause of death in American women, taking nearly 41,000 lives this year alone (Alonso-Zaldivar 1). However, the death rate from breast cancer has fallen 30% in the past 30 years (Beck 3). This is because, over the years, improvements in screenings and treatments have been made to help fight the battle against breast cancer. An individual has numerous options in term of screenings for breast cancer. Before cancer symptoms appear, breast self-exam, clinical breast exam, and mammograms screenings, can be used to detect cancer (‘What You Need to Know About Breast Cancer.’ 4).
A screening mammogram is a very common type of screening that many people are familiar with. These are recommended as annual screenings. A screening mammogram can be done at a clinic or hospital, as well as on a mobile mammography truck. These trucks can go to smaller medical clinics and even to places of employment. An employer can schedule a mobile mammogram truck to come to their building. This is a time saving convenience that employers can offer to encourage their employees to get their annual screenings. The screening mammogram can detect a lump before it can be felt (‘What You Need to Know About Breast Cancer.’ 5). If symptoms appear, an individual may undergo more tests after a screening mammogram, such as diagnostic mammography, ultrasonography, magnetic resonance imaging, and biopsy (‘What You Need to Know About Breast Cancer.’ 7). A diagnostic mammogram shows more detailed images than a screening mammogram (‘What You Need to Know About Breast Cancer.’ 7).
This type of mammogram utilizes more sophisticated equipment and must be completed at a hospital or cancer clinic. An ultrasound will show whether a lump is a fluid-filled cyst, which is not cancer, or a solid mass, which is cancer (‘What You Need to Know About Breast Cancer.’ 7). The ultrasound is also completed in a hospital setting, but is a noninvasive procedure. A magnetic resonance imaging (MRI) shows detailed pictures of tissue within the breast (‘What You Need to Know About Breast Cancer.’ 7). An MRI is completed at a hospital or specialty clinic and again, is noninvasive. A biopsy is the final test a doctor uses to determine if cancer is present or not (‘What You Need to Know About Breast Cancer.’ 7). A patient could have either a needle biopsy or a surgical biopsy. These both involve taking a tissue sample from the area in questions so that it can be thoroughly tested for cancer cells.
All of these tests are helpful in the fight against breast cancer and increasing early detection of this horrible disease. A majority of the tests are noninvasive and can increase the amount of stress that a patient has or can offer a sense of relief when the next level of testing confirms that a lump is not cancerous. Women go through many different tests each year that can cause increased levels of stress and excessive money spent on inconclusive results. There are approximately 1.6 million women each year that will have breast biopsies, with 20% or 320,000 women that will find cancer and 10% or 160,000 women that will find cells that are identified as atypia (Grady 1). Atypia is the finding of cells inside breast ducts that are abnormal but not cancerous (Grady 1). Two main controversial atypia findings are: Ductal Carcinoma in Situ and Indolent Lesions of Epithelial Origin. Ductal Carcinoma in Situ (DCIS) are abnormal cells confined to milk ducts (Beck 3. Each year 60,000 women are found with DCIS (Grady 1) and 20% of these cases of DCIS will progress to invasive cancer (Beck 3). Indolent Lesions of Epithelial Origin (IDLEs) are slow growing pre-cancerous tumors (Beck 2).
IDLEs are unlikely to progress to cancer, there is much uncertainty, among experts, on how much of a concern these really are. When women are told about the uncertainty of the findings, they may choose the aggressive treatment option to be safe. This aggressive treatment may include getting both breast removed, a bilateral mastectomy, for peace of mind and symmetry on their bodies. In fact, aggressive treatment of early stage breast cancer has risen from 3% to 20% since 1998 (Beck 3). This information shows that when experts are uncertain about how to address the test results, so are their patients, and their patients may go to extreme levels, no matter the financial cost, in order to eliminate any potential risk factors.
The cost of an individual to get screened for cancer should not be the major determinant in whether or not to get screened, however, it is one of the biggest concerns. Insurance companies across America should be required to cover mammograms for women starting at age 40 years old. For a mammogram of both breasts an uninsured women must come up with approximately $300 to pay for this procedure. As of 2010, the Obama administration requires insurance companies to cover mammograms for women 40 years and older (Kopans 2). By American insurance companies covering mammogram costs for women, women will be more likely to get a screening, and tumors can be detected sooner. Early detection of tumors leads to quicker treatment and less money spent than waiting until tumors grow or become inoperable. The cost of the disease cancer, beginning to end, is extremely high.
The cancer world in the United States alone is worth $100 billion annually (Beck 2). There is $6.8 billion being spent on unnecessary medical costs for mammograms that give false alarms and false positives and this leads to another $1.2 billion spent on overdiagnosed breast cancer (Alonso-Zaldivar 1). An individual should begin their annual mammography screen at the age of 40 years old. There are many reasons to begin these annual mammography screenings at an age younger than 40 years old. These reasons include family history, a person’s own peace of mind, environmental factors and so on. The American Cancer Society recommends that annual screenings start at age 40 years old (“American Cancer Society” 2). There has been no biological, medical, and or scientific reason to not start screening until 50 years old (Kopans 2).
The American Cancer Society’s recommendation and scientific reasonings show that all women should be able to start screenings at the age of 40. Starting annual screenings at age 40 years old can be more beneficial in the long run because it could catch and treat a tumor before it is too late to treat. Many foreign countries have conducted experiments that show screenings starting at 40 years old is a major factor in the decline of breast cancer related deaths (Kopans 2). Approximately 15,000-20,000 lives are saved every year from breast cancer with screenings, detected lumps and prompt treatment (Kopans 2).
By finding tumors sooner treatment can be started and many more lives can be saved. Waiting until 50 years old would just give these tumors more time to grow and potentially spread throughout the body. It is true, in some cases, that an individual’s stress, anxiety, and money can be saved by waiting until the age of 50 years old because of misinterpretation and overdiagnosis. Women can choose not to have their annual mammogram, but the task force and insurance companies should not be making that choice for them. It is a proven fact that early detection is the key to success in the battle against breast cancer today. Beginning screenings at the age of 40 years old years, a women can have a greater chance of early detection and a better chance to beat cancer. There are many more battles to be won, the sooner they are started, the quicker they can be won.