Mammograms at 50: A Female Doctor Speaks Out

By Lissa Rankin, MD

thermographyMy father was a radiology doctor who specialized in mammograms, so I grew up around those machines that take two perfectly good knockers and squash them into Swedish pancakes. Dad used to joke that if women were in charge of medicine, men would have to stick their penises between two plates and get “manograms” after the age of 40.  When I was young, I remember sitting beside Dad in the dark screening rooms while he inspected film after film, hunting for subtle signs that might signal breast cancer. He likened it to reading a Where’s Waldo book. Mammograms may seem like torture, but they also may save your life.

But we all know that. Why am I writing this post? Because the U.S. Preventative Task Force just declared that women in their 40s of “normal risk” should no longer get routine mammograms.  They also say women after 50 should only get mammograms every other year, recommend against teaching breast self-exams for all women, and say no mammograms after the age of 74.  WTF? What changed since they recommended mammograms every 1-2 years in women over 40?

Okay, so mammograms are far from perfect. So we’re gonna throw all progress we’ve made in reducing breast cancer mortality out the window?  What about new advances in digital mammography?  What about my patient who just potentially saved her own life by finding a breast cancer while examining her breasts? What about Mrs. Olivier, my amazingly vital 81 year old patient whose mammogram found an early breast cancer ten years ago and is still alive and kicking after treatment?

Okay. So it’s true. Self breast exam data isn’t stellar. Large studies have shown it to be pretty ineffective, actually. But what about those few women who do detect their own cancers and save their own lives?  Plus, what’s the harm in feeling your boobies for lumps? And what’s with the recommendation against mammogram in women after 74? These are the women at highest risk, for whom mammography screens most effectively. All of the sudden, Grandma is no longer important? Have I just stepped into some alternate universe? I mean, seriously, people.