May 24, 2002 (Executive Health Exams) - A recent study published in the British medical journal Lancet
called into question the value of yearly mammography. This study sparked
a storm of debate, both in the professional and the lay press, about
the value of routine mammography as a means of preventing deaths from
breast cancer. Please consider the following before you or someone you
love forgo a yearly mammogram:
· There is currently no better method for the detection of cancer
at a very early stage than yearly mammograms. The smaller the lesion,
the better the survival and the greater the likelihood that a breast-saving
procedure can be performed.
· Mammography is an imperfect screening study. It cannot identify
every cancer. About 10% of breast cancers are not visible on mammography.
Mammography cannot predict which carcinomas in situ (cancer cells
confined to the lumen of the breast ducts) will progress to become invasive
cancers. This can only be determined by biopsy and careful pathology
evaluation.
· At time of diagnosis, all breast cancers are staged.
Staging provides a means of describing cancers by size, the possible
involvement of surrounding lymph nodes, and by evidence of the spread,
or metastasis, of the cancer. Stage 0 and Stage 1 breast cancer
are the least invasive and smallest cancers, and are associated with
the highest survival advantages (an over 95% five-year survival rate,
according to the National Cancer Database). In a report issued by the
cancer committee at Alexian Brothers Medical Center (ABMC) in Elk Grove,
Illinois [where Dr. Hallenbeck practices], 51% of new breast
cancers detected at ABMC in 2001 were Stage 0 and Stage 1. These cancers
were found almost exclusively by means of yearly mammography. It is
safe to say that tens of thousands of women owe their lives to mammography.
Researchers are now seeking better methods of screening for breast
cancer in the hope that we will one day be able to detect precancerous
breast cells. Until then, mammography remains the only means we currently
have of detecting breast cancer at the earliest possible stage. Let
the statisticians battle it out: all women should have a yearly mammogram
beginning at age 40, coupled with a clinical breast exam by a
qualified health care provider, and should perform monthly breast self-examinations.
This will provide the best possible advantage in discovering the most
curable breast cancers.
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George
S. Hallenbeck, MD, a board-certified radiologist, formerly
served as Chief Operating Officer, Department of Radiology, at
Alexian Brothers Medical Center in Elk Grove Village, Illinois,
and is currently an Attending Radiologist at that hospital. Dr.
Hallenbeck has also chaired the Department of Medical Imaging
at Gottlieb Memorial Hospital in Melrose Park, Illinois, served
as Attending Radiologist at Oak Park Hospital in Oak Park Illinois
and has directed the X-ray Technology Program at Triton College
in RiverGrove, Illinois. Dr. Hallenbeck currently sits on EHE's
Medical Advisory Board.
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Alyce
Kuklinski, RN, NP, directs the PersonalMD Program at Executive
Health Exams International. A graduate of Duke University, Alyce
holds a graduate degree in nursing from the Institute for Health
Professions at Massachusetts General Hospital in Boston. Her background
is in clinical nursing, public health, and research. In addition
to her work at EHE, Alyce also practices as a Women's Health Nurse
Practitioner in New York City.
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