©1997, ProMotion, inc.
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Q: In your Op-Ed piece, "Luckily, I Had a Mammogram," which appeared in the New York Times on January 29, 1997, you discuss your belief that women in their 40s should get mammograms. Can you tell us a little bit about your feelings on this subject?
A: Many studies seem to indicate a positive benefit from mammograms for women in their 40s. The real question being considered is whether the number of lives saved justifies screening so many women, some of whom will need biopsies. As a woman who found her breast cancer through a mammogram I of course feel its worth the trade off. When I was 43 years old, I struggled with the decision to get a mammogram--I had read the conflicting reports on both the effectiveness and the safety of mammograms--but in the end I decided to get the test. I knew a number of women who had been successfully treated for early breast cancers that had been discovered when they had mammograms. When my mammogram detected a tumor, I became an anomaly to the statistic that not only said breast cancer is more common in women in their 50s, but that mammograms are ineffective at detecting breast cancer in women in their 40s.
Q: You refer to the risks posed by mammograms as "acceptable risks." Many women feel that the possibility of early detection of breast cancer by far outweighs the small risks of mammograms. What are the risks?
A: Radiation from mammograms may pose a small risk to women who are genetically susceptible, and biopsies involve the risks that are normally associated with any kind of surgical procedure. However, when I weighed the risks of having a mammogram against the possibility that cancer could be present and could spread were it to remain undetected, I found the risks to be negligible. Early detection is still the main line of defense against cancers that spread quickly and require immediate, aggressive treatment.
Q: How does your own experience and the experiences of other women you've met affect your position on mammograms for women in their 40s?
A: After learning that the "suspicious calcifications" seen in my mammogram were in fact cancer, I made an appointment at Memorial Sloan-Kettering Cancer Center for a second opinion. In the waiting room I talked to other women who had breast cancer. None were over 50 or had a history of breast cancer in their families. One woman of 40, the mother of a three-year-old, had not had a mammogram; if she had, she told me, her breast cancer might have been caught before it spread to her bones. Many women that I know, and I myself, have benefited from mammograms. Yes, my evidence is anecdotal, but it is evidence I can not ignore. Abstract talk about statistical significance has absolutely no relation to my experience.
Q: What is your opinion of the recent NIH decision against recommending mammograms for women in their 40s? Do you think there is a danger of insurance companies basing their coverage policies on the NIH decision?
A: The information available on the reliability of mammograms is widely conflicting. Although the NIH does not recommend the test, the American Cancer Society will continue to recommend mammograms for women in their 40s. One would hope that insurers will not deny coverage of mammograms for women of this age group because of NIH's decision. This is why I believe that Congress should pass the legislation proposed by Representative Jerrold Nadler of New York requiring insurers to pay for early mammograms. In his letter to the editor in the February 4 New York Times, Senate Majority Leader Joseph L. Bruno says "these tests are still the most effective tool we have to detect breast cancer in its earliest stages." Fortunately, New York has two state laws that require coverage of mammograms for women beginning at age 35. Hopefully, other states will soon follow suit.
©1997, ProMotion, inc.