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November 18th, 2009
10:46 AM ET

Do risks of routine mammograms really outweigh benefits?

There are millions of women today who are now questioning the best strategy for detecting and fighting breast cancer.

New guidelines from a government task force advise women to now wait until they are 50-years-old, not 40, to start getting routine mammograms.

So, do the risks of routine mammograms really outweigh the benefits?

To get a perspective from all sides, we talked to: Julie Sisskind, a breast cancer patient without any family history, who was diagnosed from a routine mammogram; Lucy Marion, one of the members of the task force that created the new guidelines; and our own Dr. Sanjay Gupta, CNN chief medical correspondent and practicing neurosurgeon.

Since the new recommendations have the potential to affect the health and well-being of millions of American women, it's not surprising that there is a deep concern from many over what this all actually means.

At times heated, this is an interview you don't want to miss.

Related: Breast 'awareness' trumps self-exams, docs say

Filed under: Controversy • Health
soundoff (32 Responses)
  1. Carmen

    I had a negative mamogram,no lumps, no history of any cancer in my father and mother family, they usually reach 100 with no ilnesess or cronic problems, I ruin the Gene pool.
    I asked, begged to have more test done because I had pain in my breast,finally a dying women wrote to Dear Abby about nobody listening to her, I took the copy to a surgeon,well I had an excitional biopsy it was Carcinoma,I was recommende not to have further treatment, I demanded a mastectomy and Chemo,,during surgery they found a Lubular invasive cancer, thanks to me I am alive 15 years later, do not listen to nobody if you want a mamogram,ultrasound, second opinion,MRI demand one, I work now with cancer patients and many died because they were not listen.

    January 16, 2010 at 7:45 pm |
  2. Andi Chasar

    It is a disgrace to women everywhere to think that there are people who actually believe that having a mammogram is not important.Thousands of womens lives have been saved because of routine or early detection.After all,finding cancer after it has spread is when its to late.If one of the women who make up the panel were saved because of early detection,then would it become important again.Or perhaps women should just go to a veterinarian for health care.I mean if your going to treat us like cattle,then you might as well go all the way with it.To many women have already died because of misdiagnosis,so if one simple test would help keep us alive,then whats the problem.

    November 19, 2009 at 4:54 pm |
  3. ResearchBasedGal

    I have reached a conclusion after doing research on the topic that the new guidelines make sense. Mammograms do expose women to radiation and even if it might seem small at any one instance, the cumulative effect is quite a different case. DCIS (a type of breast cancer) cases increase by 300% in women who are exposed to regular mammograms. If medical professionals are so concerned with women getting scans for their breasts regularly, why don't they recommend breast MRIs which are much less invasive and don't expose you to radiation and have much fewer false positives/negatives and they work well for even denser breasts which is the case for women in 30s and 40s.

    November 19, 2009 at 11:44 am |
  4. Sue Carres

    Lucy is a robot. She cannot seem to engage in an intelligent conversation on this subject – she just repeats herself over and over with eyes cast downward. Pretty sad. I am a 19 year breast cancer survivor. I was diagnosed at the age of 44, no risk factors, no family history. I'm alive nineteen years later Lucy – because of early detection. Ask my children, ask my 12 grandchildren, ask my friends and family – does my life have value? You and the task force are negating that value for thousands of women? The CONVERSATION is taking place NOW. Listen to what we're saying. Don't look at the ground and repeat what you've been told to say. Stand up for yourself and all women. Join the ranks of your women who are passionate on this subject. Don't watch us die.

    November 19, 2009 at 11:26 am |
  5. jim

    This is just the first of what will become many recommendations to cut back on preventive care covered by insurance. It will save the government countless millions when they finally strong-arm us into mandatory government health care. It would look too suspicious to wait until the program is implemented, they will try to get as many of these recommendations for preventive testing removed before the takeover as they possible can. Few, however, will get the press coverage of this one. You won't find out until you want a test that it was removed from the required preventive test list "ages ago".

    November 19, 2009 at 9:31 am |
  6. renee rehkemper, chicago

    It is obvious that mammograms are not the answer with those statistics... what about thermography as the breast cancer screening method?

    November 19, 2009 at 9:15 am |
  7. Adrian

    Dr. Gupta just said that prostate screenings has not been linked to saving lives?? How could it? its still up to the individual to do what is necessary to take care of themselves, but how do you do that, if you don't know something is wrong? His statement is a bit troubling to me, since we have always been told that early detection is key to any and all treatment.

    November 19, 2009 at 9:02 am |
  8. Avalanche

    It's interesting to me that the argument against mammograms is that they do not save enough lives. But is it really a life or death situation? Don't mammograms save BREASTS???? Isn't there value in that?

    November 19, 2009 at 9:01 am |
  9. Mary Ann Fowler

    My doctor has ordered cholesterol screenings every 3 months with each one resulting in a different, expensive prescription drug to try to lower my cholesterol. I can't help but wonder how long it will be before the recommendations for this practice goes the way of the mammogram recommendations. Far more people will be affected and the logic is the same: anxiety causing, few proven results, side effects etc. What other "needless" preventive care is being looket at?

    November 19, 2009 at 8:44 am |

    Instead of trying to reduce coverage of test why not figure outhow to reduce the cost of care. As long as mamograms has been around why do they still cost so much. Lie computers the cost of mamograms should be going down after all this time.

    November 19, 2009 at 8:05 am |
  11. T Murray

    I am a nurse. Why is a nurse in charge of my mammogram? Why is SHE an expert? What makes her an expert? She is a Robot. She should quit her job and bow out gracefully. She has betrayed herself in every way. Nurse?..some nurse. Expert..? NOT!! Come clean you sell out!!! Shame on you, and I wont even ask if you have daughters or grandchildren.

    November 18, 2009 at 11:57 pm |
  12. befuddled.

    but I am sure viagra etc. is covered by insurance.

    by the way, a routine mammogram saved my life at 47.....

    I am not in a risk group.

    November 18, 2009 at 11:29 pm |
  13. Betty

    Hello, I do not agree with this guideline. I was diagnosed with breast cancer at the age of 45. It had spread to my lymph nodes (stage 2). I have no family history of breast cancer. If it wasn't for the mammogram, I think I wouldn't be around. Thanks,

    November 18, 2009 at 9:54 pm |
  14. Carol Stover

    Hi Rick, I enjoy your show and would like to comment on the mammogram issue. When I took a mammogram at age 38, the mammogram showed negative even though I had a lump. A few months later, it was as though you placed a charbroiled steak on my breast and I could not sleep on my right arm for it was so painful. Needless to say, I went for another mammogram. I had a stage IV breast cancer...a 7cm tumor. Being the oldest of five siblins, I was the first to get cancer. I still feel mammograms are a must even before the age of 40, depending on the case. Can you see why? I am considered to be a miracle. Thank you!!!! Carol Stover from Tn.

    November 18, 2009 at 7:46 pm |
  15. Anne RN

    Sanjay – Everything you learned in your medical practice was based on groups of scientists comparing evidence to choose the best practice. New evidence can help consumers spend their precious health care dollars. Very young women and even men get breast cancer. Does EVERYONE in your family have a mammogram EVERY year? I had my first one when my plan covered it, and it showed a suspicious spot. This led to a needle biopsy, done DURING AN ACTUAL MAMMOGRAM. I had young children and was changing jobs and health plans. It was 7 weeks of torture before I knew that I did not have cancer. It was JUST a false positive. Then I began subconsciously to delay self breast exams and to skip annual mammograms for a while. I bounced back and I felt fortunate. I am a nurse though, so I knew that there is a cost to every screening procedure. Something else cannot be done, for you, or for your loved ones. This Task Force reports on the results for women. They do not make the decisions about who gets care or who pays for it or how many oncologists and radiologists we can finance. They need some hellp to remind Americans that many studies like this are necessary, so that their personal physicians, nurses, insurance companies, and Medicare can argue out EVERYTHING they are going to recommend or pay for. Please do not trash the messenger for the excitement of shocking viewers with how hard it is to decide on screening tests and medical treatments. We are not afraid to learn. Maybe the new breast MRI should be done at 35 and then every few years. What’s the evidence? How much would I have to pay? Should I keep it up indefinitely?

    November 18, 2009 at 6:51 pm |
  16. Richard

    My non-smoking, not overweight, no history of breast cancer wife that exercises 2-3x/ wk was diagnosed with DCS (precancer) in her early fourties. She had a mastectomy. She continued to have mamograms every 6 months,and insisted on having both sides done despite assurances that the one side only contained "tummy tissue from the reconstruction". Good thing, as some breast tissue is often missed during a mastectomy! After a 3 years the mamogram was up high enough towards her armpit to pic up the stage 2a breast cancer. More surgery on the same side, chemo, radiation. Next month will be 5 years clear. My wife may be statistically insignificant... but she's alive and I think my best friend is worth the price.

    November 18, 2009 at 4:29 pm |
  17. Michael

    This approach coming fast upon the previous recommendations only six months ago (in which the Board suggested "A routine mammogram annually beginning at the age of 40.") , should be the wake up call to all Americans that a move toward a government controlled medical insurance program will lead to dramatic, about-faces in what is perceived as good, safe-sided approached to your personal health care.

    Welcome to the rationing, delayed treatment, public health approach enjoyed by people of "socialist" countries around the world!

    November 18, 2009 at 4:06 pm |
  18. Georgetown Girl

    I think all of these questions about where to draw the age line for when routine mammograms are necessary are unhelpful, insulting to cancer survivors, and immature.

    Who cares about false positives and biopsies of benign tumors? Sure there are added costs to you and your health insurance, but I think that making sure you are safe and well is worth it. If you are under 40 and cancer free, you essentially ring up $1000 in mammogram fees over ten years for good news–not so bad! If you do have cancer, isn't that $1000 worth the chance to fight for your life with the advantage of early detection?

    Women fight and beat cancer every day. There is no magical pill you can take to be rid of cancer for sure, but the medical community has come such a long way in the past decade to improve treatments. The earlier you find it, the better you are. Young women like Julie, who had no reason to expect their cancer need the opportunity to fight their diseases and live a long and happy life. When their daughters reach forty, they should have those same opportunities.

    And Maryland Lady, when your mammogram comes back positive one day, believe me, you'll think that saving your life will be worth it. And I would agree with you.

    November 18, 2009 at 2:45 pm |
  19. maryland lady

    Here's my "anecdotal science": Every woman I know who has died of breast cancer was religious about her mammograms. Therefore, because we now want medicine by anecdote, mammograpy is useless and no one should get a mammogram. Hey, my sad stories have every right to drive medical treatment, just like your sad stories.

    November 18, 2009 at 2:19 pm |
  20. Amy Motto

    Thge Sanje Gupta story this (11/18) am that grabbed MY attention was the one on folic acid and vitamin B12 leading to 23% increased cancer risk! I take B12 shots every month for a very effective energy boost (I have Multiple Sclerosis). Do they have folic acid in them? Who can I ask? Do they fit into the same study results? I have e-mailed the show but dobut that I'll ever get a direct answer. I doubt if my doctor knows. Do I have to find out and call the manufacturer?

    November 18, 2009 at 2:14 pm |
  21. v

    Well I went to have a mammogram done in fall of 2001 nothing there, the following year (fall 2002) I went for my female check up and the doc said you have a lump, go get a mammogram and lets see what it is. I went and got the mammogram and had to see a surgeon and I had surgery because they couldn't tell what it was with a biospy. Three days after surgery (lumpectomy) the doc call and said that I had stage 2 invasive cancer. You can't go even one year without having a mammogram. It would be stupid. I would have a mammogram even if I had to pay out of pocket. I had chemo and radiation and 5 years of the follow on drug Adrimdex and I go for a mammogram every year. I have been cancer free since then.

    November 18, 2009 at 2:12 pm |
  22. mesnyder111

    In addition to what I stated previously, there is also the following issue: The way in which they've chosen to translate their scientific findings for a non-scientific public (i.e., using language like "small" benefit).

    These people need a course or two in public relations.

    True, there is the question of "where do you draw the line" at routine mammograms? They crunch the numbers, and decide that more money could be better spent on things other than routine mamm's prior to age age 50.

    Statistically, that may be correct. I'm not checking their math. But here's the issue: We're humans, not heartless, and it appears that the American public has decided that there have been ENOUGH women diagnosed with breast cancer in their 40s that mamm's should remain routine for them. And that is a value that I share.

    The task force publishes their numbers - but it's humanity that decides what value should be placed upon them.

    This is quite a slippery slope. If we start playing a numbers game like this, how many other treatments will no longer be routine? How many other people battling other diseases will find that, because the numbers don't add up, they won't find out they have a heart condition or prostate cancer before the disease has advanced to incurability.

    Slippery slope indeed. I heartily disagree with the task force. Their values are not my values.

    November 18, 2009 at 1:58 pm |
  23. Texas Survivor

    Well, chalk this up to the beginning of the decline of our health care, and isn't is special that they are endangering women's lives right off the bat to do it! I just can't believe the government task force(as if we ALREADY had enough trouble trusting anything they do!) made this stupid new guideline . What idiots. Actually, they will be saving SOOO many millions of dollars for the government in the new health care deal by LOSING SOOOO many women to breast cancer on this thing, therefore not having to pay for their treatments, etc. Isn't that special!!! I am 62 and I was diagnosed with breast cancer when I was 54. Thank God it was caught early to save me. I know a lot of women who have died in their 40's from this disease. I'm so stunned by this, I can't tell you. Sisters out there, SPEAK YOUR MIND ABOUT THIS!! We can't let them get away with it!!

    November 18, 2009 at 1:51 pm |
  24. chris james

    Nice hit job on the nurse. I thought your interview was overly emotional,
    unprofessional, and very un-Gupta like.
    I saw you how you steered the conversation as to risks into anxiety
    instead of the inherent dangers of repetitive mamagrams.
    Now the buzzwords "rationed care"
    Focus on insurance company financial interests
    but not the medical industry?

    I thought you were better than this.

    November 18, 2009 at 1:44 pm |
  25. Van Dyne

    These people are idiots. Listen to them talk, what direction is our country going; right in the crapper. I would be a single parent if my wife would have followed this guidance.

    November 18, 2009 at 1:34 pm |
  26. maryland lady

    Folks, we can either have medicine based on science, or medicine based on magical thinking. Which do you want?
    How many lives could be saved if all women had monthly mammograms, starting at age 12? If it saved one life, wouldn't that be worth it? Please – get a grip!
    I am so glad this report came out, and that the facts are finally being discussed. The powerful, billion dollar, pink ribbon cancer industry has so inculcated into our heads the "early detection saves lives" nonsense, that mammograms have long since ceased being a mere diagnostic test, and have morphed into some kind of quasi religious sacrament, which women will no more question than they would question Holy Communion. Women demand more and more mammograms and cling on to them like blankies because all the billions of pink ribbon dollars "for the Cure" have produced no cure at all in the past 3 decades.
    Finally, as has been noted before, the plural of anecdote is not data. Let's get back to science.

    November 18, 2009 at 1:32 pm |
  27. mesnyder111

    Was the woman from the task force being deliberately obtuse? I'm stunned at the flawed logic here. The task force says that routine mammograms shouldn't begin until 50, instead of the previously recommended 40, unless there are other factors like a family history of the disease.

    Yet a HUGE percentage of cancers occur in women with NO family history. If this new recommendation were followed, what in the world would cause a woman and doctor to agree that she should be screened if there were no family history to compel it? And now, what's to stop insurance providers from paying for routine mammograms, when they can simply say that the government agrees with them???

    This task force has to be in the pocket of insurance providers. (I know, what's new there?)

    This is outrageous.

    November 18, 2009 at 12:42 pm |
  28. Jeff Sloane

    The idea of woman under the age of fifty not having routine mammograms is simply absurd. Following her "routine annual mammogram", my wife was diagnosed with an invasive breast cancer; at the time, she was only 42 years old. Her breast surgeon and oncologist stated that had her disease gone un-diagnosed until she exhibited frank physical symptoms, her cancer could well have been fatal. Instead she underwent a bi-lateral mastectomy. She has been cancer free ever since. (nine years)

    She has been part of a breast cancer support group since shortly after her surgery. The majority of this group was diagnosed thru a routine annual mammogram, prior to the age of 50.

    This is a part of the health care system that works well and is extremely cost-effective. The people that made the new recommendations should go live on a desert island and not worry about being exposed to modern health care.

    November 18, 2009 at 12:40 pm |
  29. AnnaMayBe

    My mother found a lump 3 months after a twice-yearly mammogram in mid-2007. Biopsy done within a month – diagnosis: Stage III. Gotta operate, they said, but first we do an MRI. Oh boy, MRI says the cancer is too attached to chest wall, so chemo first, then surgery, then radiation. All is well until Oct 2009 when she died from undiagnosed Stage II colon cancer. How was it missed? No recent colonoscopy says the doctor; yet her "long-ago" colonoscopy was in 2008!

    Bottom line – x-rays are not worth the film they're developed on. Get an MRI. Don't depend on a mammogram !!!

    November 18, 2009 at 12:26 pm |
  30. gabirdgirl

    This recommendation makes me so angry. I can't believe that the percentages of lives saved doesn't outweigh the anxiety one has to go through when getting a biopsy. I have experienced that anxiety, and I would welcome it any day if the result was negative for cancer. As it stands, I am a 37 year old woman with no family history of breast cancer who was just diagnosed with Stage I breast cancer. I went into my primary care physician and asked for a baseline mammogram a month ago- and thank god I did. If I were to follow the recommendations of this Task Force, I wouldn't be alive in time for my first screening mammogram at age 50.

    November 18, 2009 at 12:09 pm |
  31. JShadoff

    I feel very lucky as I am 80 years old My first diagnosis through mammography was in 1969 – had a mastectomy as the biopsie was cancer no chemo or radiattion.
    In 2001 had a mammography and biopsy which resulted in a
    I am for mammography as a life saver and also have a daughter &
    grandaughters & feel if it can save lives then it should be given to
    any women who at any age feels it is a preventive medicine
    It should be allowed by insurance A life is a small price to pay for by insurance
    Early detection is what it is all about

    November 18, 2009 at 11:29 am |
  32. Brian Menker

    Can someone out there just tell this Lady that she got her 5 minutes of fame, now she can stop fighting for something pointless?.. How do we even get 10 minutes of conversation out of these nut cases? Obviously her analysts of the given stats have IQ's equal to their shoe size... She is on my list of people that I can go my entire life w/out ever hearing her voice again.

    November 18, 2009 at 11:20 am |