As a breast cancer survivor Tanya Matthews doesn’t discount the effectiveness of mammograms in saving lives.
Tanya Matthews of Pasadena believes routine breast screening for women should begin earlier than the province’s mandated 40 years. — Photo by Geraldine Brophy/The Western Star
At age 36, Matthews was several years away from qualifying for routine screening under the province’s Breast Screening Program when she found a lump in one of her breasts.
Had she not found out about her cancer four years before routine screening, there could have been a darker outcome for the Pasadena woman.
“By which time my cancer probably would have been fatal,” she said Wednesday.
In Monday’s edition of the BMJ (formerly the British Medical Journal), Canadian researchers concluded an annual mammogram in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination.
The 25-year followup for breast cancer incidence and mortality of the Canadian National Breast Screening Study found that 22 per cent (106 out of 484) of screen-detected invasive breast cancers were over-diagnosed, meaning there is about one over-diagnosed breast cancer for every 424 women who received a mammogram.
It was an ordinary Thursday night in late 2011 when Matthews discovered a lump in one of her breasts while getting ready for bed. She saw her doctor the next day and the following Friday underwent an ultrasound, a mammogram and a biopsy.
“A long week” later she got the diagnosis.
Five weeks after she discovered the lump, Matthews underwent a double mastectomy. That was the recommendation she received from health-care providers based on her age and family history.
“I know that menstruating women’s breast tissue changes monthly,” said Matthews.
“There’s lumps and bumps and mammograms aren’t necessarily always accurate in detecting tumours.”
In her case the mammogram detected one lump, but an examination of her breasts after the mastectomy found two lumps and the one detected by the mammogram was bigger than measured by both the ultrasound and the mammogram.
“So it wasn’t necessarily accurate, but it was inaccurate in the wrong way. It was less accurate than it should have been.”
Needed for peace of mind
Matthews said mammograms are probably detecting more benign things than they are cancer,
but for women’s peace of mind, she said, screening should start at age 35.
“In my instance if I’d been diagnosed at 35 instead of at 36, things may have been different.”
It wasn’t till 2012 the age for screening was moved back to include women aged 40 to 49. Women in that age group require a doctor’s referral for screening, while those age 50 to 69 can self refer.
Matthews said her journey hasn’t been easy. “I’ve had several complications and just trying to get back to my normal self ... It’s been a difficult adjustment, but I’d do it all again to have the peace of mind.”
Screening saves lives
The Canadian Breast Cancer Foundation takes the position early screening and detection does save lives.
Angie McAuley, senior director, communications and health promotion for the Canadian Breast Cancer Foundation, Atlantic Region, said there are many studies that prove that.
“And there are women who are living today that say it does.”
McAuley said the foundation believes what’s important is to put women’s health first, and notes the study has been heavily criticized for more than 20 years because of limitations with the methodology and findings.
“We feel that it’s adding to the confusion that women already have about breast screening because there’s evidence that suggests that regular screening saves lives,” she said from Halifax.
“Women are mothers, and sisters, and daughters and we need to put women first,” said McAuley.
“We encourage women age 40 to 49 to speak with their family physician or their health-care provider about what the right decision is for them. And then women who are 50 and over are able to self refer in Newfoundland and Labrador, so we encourage them to do so because early detection through screening saves lives.”