Downside to mammogram screenings

False positives are a huge deal

NEW YORK (CNN) – New guidelines issued Tuesday by the American Cancer Society. The organization says women should start getting mammograms at 45 instead of 40.

Elizabeth Cohen, CNN: “Do you understand there’s something that’s not completely intuitive here? Cancer’s scary, I want to do everything I can. So what are the downsides of mammography?”

Dr. Otis Brawley, Chief Medical Officer, American Cancer Society: “Especially as women are younger you’re more likely to get a false positive. You’re more likely to be told there’s something wrong with this mammogram we need to do further testing. Further testing can be more mammography, which is more radiation or can be biopsies or other things as well.”

Elizabeth Cohen, CNN: “Are false positives a big deal?”

Dr. Otis Brawley: “False positives are a huge deal.”

Elizabeth Cohen, CNN: “Why?”

Dr. Otis Brawley, Chief Medical Officer: “I know women who have had mammography ever year starting at the age of 40. They get five mammograms they have a false positive every year it leads to ultrasound MRI leads to biopsies. They are so frightened and inconvenienced they swear off mammography for the rest of their lives.”

Elizabeth Cohen, CNN: “Many women have told me I’ll take the false positive in exchange for being vigilant. False positive that’s okay, I’ll live through it at the end of the day they’ll tell me I don’t have cancer, but let me decide that.”

Dr. Otis Brawley, Chief Medical Officer: I am totally in support of that and that’s why our guideline says if a woman is 40 to 44 and she wants to get screened she should be screened. If she waits until 45 she decreases the risk of false positives throughout her entire lifetime dramatically.”

Elizabeth Cohen, CNN: “Why are mammograms particularly problematic for women in their early forties?”

Dr. Otis Brawley, Chief Medical Officer: “Density on the mammogram is white the tumor that we’re looking for is white.”

Elizabeth Cohen, CNN: “So looking for a white tumor on a white background.”

Dr. Otis Brawley, Chief Medical Officer: “Is very difficult. The chances that mammography is actually going to save your life is not very significant as a woman ages and loses density of the breasts. The breast on mammogram becomes black and this is the reason why mammography actually clearly saves lives for women in their fifties and sixties because you can see the tumor better.”

Elizabeth Cohen, CNN: “So if you have a group of twenty women where we could look into a crystal ball and we know that all twenty are going to get breast cancer and die.”

Dr. Otis Brawley, Chief Medical Officer: “It’s going to catch 15 or 16 of the 20 cancers but it’s only going to prevent four from dying.”

Elizabeth Cohen, CNN: “Because it’s catching it too late?”

Dr. Otis Brawley, Chief Medical Officer: “That’s right, it may even appear that we have caught it early but ultimately when the patient dies we know. It seemed like it was early but it actually was not.”

Copyright 2015, CNN. All rights reserved.

Comments are closed.