I’m all about high-value, evidence-based healthcare.
And because October is Breast Cancer Awareness month (Think Pink? Think Twice!), I want to share this video by Andrew Lazris, MD, and Erik Rifkin, PhD. They use the visual of 1000 women sitting in a theater to illustrate why screening mammograms probably won’t save your life.
A picture (or video) is worth a thousand words, isn’t it?
The harms of screening mammograms
As mentioned in the video, more women will be harmed by screening mammograms than helped. One life will be saved (which I get is all that matters if it’s your life), but hundreds of women will suffer the pain, side effects, inconvenience, anxiety, and cost of unnecessary surgery.
And despite the aggressive marketing campaign, 3D mammograms may not be any better. But they are definitely more expensive! Not all insurance companies cover them 100% like they do for the standard 2D mammograms—check with your insurance company.
I’ve written many posts about the problems, including high costs, of overscreening and overtreating. Did you know we spend hundreds of billions of dollars every year on unnecessary healthcare?
I think there’s too much marketing of screening exams and not enough meaningful education.
“Mammograms save lives” is a great catchphrase, but it certainly doesn’t explain the risks and benefits.
Don’t be pushed into scheduling a mammogram because of an advertisement. Shared decision-making involves talking with your physician about the pros and cons of any test or treatment.
Shared decision-making takes into account your personal health history, your family health history, and your health values or goals.
Ask questions until you really understand the limitations and possible risks; then make a plan that works for YOU.
Different women will make different choices.
I like this video showing how shared decision-making works for screening mammograms.
Finding reliable information
Personally, I don’t think we’re talking enough about screening mammograms. Like so much in medicine now, benefits are hyped and risks are downplayed. Profits matter more than health.
And it really bothers me that other entities are getting in between us and our physicians, and undermining shared decision-making.
Some doctors are financially penalized if their female patients don’t follow the screening mammogram guidelines set out by insurance companies, or some government agency.
Most doctors don’t have the luxury of time to spend on shared decision-making, either. Many are burnt-out and find it easiest to just click the box on the computer screen that says they discussed screening mammograms with the patient.
Sigh. As always, the burden is on the patient to be informed and ask lots of questions.
Here are some sources that I think have reliable information on mammograms and screening guidelines:
- The United States Preventive Services Task Force (USPSTF)
- The Centers for Disease Control (CDC)
- Journal of the American Medical Association (JAMA)
- National Institutes of Health (NIH)
- Science-Based Medicine (SBM)
Being an informed patient will maximize the chance a screening mammogram will help rather than hurt you.
Check out my Resources page for more links to good evidence-based medicine and shared decision-making websites.