Can You Trust Your Mammogram?
By Fran Smith
Why even smart doctors miss breast cancer - and how to make sure you're
getting the best care.
No matter what you know about other diseases, breast cancer is probably the
one that scares you most. It is frightening, striking nearly 182,000
women this year and plunging them into a world of complicated, arduous
treatment. So it's heartening to know that more women are being diagnosed
early, when the odds of beating the cancer are as high as 98 percent.
Prevention and treatment are becoming personalized, thanks to genetic tests and
new types of drugs. And after decades of no change, the death rate has finally
begun to drop — about 2 percent annually since 1990.
Yet behind these impressive statistics lies one dumbfoundingly scary fact:
Just because better tools and treatment exist is no guarantee that
you'll get any of them. Your mammogram could be interpreted inaccurately, a
lump could be incorrectly diagnosed, and you may not receive the best treatment
for you simply because of where you live, the type of surgeon you choose — or
even the doctor's sex.
That's why it's more important than ever to know the right questions to ask.
Breast cancer is a complex disease (some researchers suspect it's at least five
genetically distinct conditions), and no single approach works best for
everybody. At every step — when you have your annual mammogram or get a
suspicious lump checked out or undergo treatment — you should, at the very
least, receive care that meets the scientific guidelines issued by leading
cancer organizations. Here's how to make sure you do.
When you get a mammogram, it's common to have a stab of anxiety about what
the radiologist will find. What should also concern you: the doctor who's doing
The news: In a new study, researchers reviewed nearly half a million
mammograms performed at 44 facilities. At the best centers, doctors identified
cancer when it was present just about 100% of the time; at others, that number
was closer to 70%, says study leader Stephen Taplin, M.D., M.P.H., a senior
scientist at the National Cancer Institute. Facilities with a breast-imaging
specialist (defined here as a doctor who spends at least half her time reading
mammograms) had the best record.
Why it matters: Getting a regular mammogram is key to finding breast
cancer early. Five-year survival rates drop from a high of 98.1% for early,
breast-only tumors to 27.1% for advanced cancer that has spread to distant
What you should do: When you call for an appointment, ask if there's
a breast-imaging specialist on staff. If not, shop around, advises Diana
Miglioretti, Ph.D., a researcher with the Group Health Center for Health
Studies in Seattle. "I'd go to someone who has been interpreting screening
mammograms for at least 10 years."