Breast Screening Rate is Down…But Why?

Hello bOObs Bloggettes:

I read an interesting article put out by MedPage Today stating that the breast cancer (BC) screening rate has dropped from 74.1% to 67.1% from 2009 to 2016. Let’s look at why this might be so.

First of all, the authors writing the analysis for an article in the Journal of the National Comprehensive Cancer Network (the NCCN is the keeper of such figures) were scratching their heads as to why this drop occurred, particularly in BC survivors. Well, as we’ve discussed previously, 2009 was the year that the big announcement was made by the likes of the American Cancer Society and the U.S. Preventative Services Task Force (the latter started the tumbling of dominos) that women should put off screening until 45 and 40, respectively, and then go to every other year for certain age categories. This change really confused women (and doctors) and the media was unsure of how to report it.

I have nothing but instincts to base this on, but I would assume part of the decline is those change in guidelines, but also women perhaps turning away from mammograms due to their concerns — even for a follow up screening to their previous breast cancers. 

One big question is: How many women no longer going for screening were diagnosed with DCIS, which is a precancer (see previous blog)? Because it was during this makeover of the BC screening guidelines that it came out that women were being over-diagnosed and treated for this Stage 0 precancerous condition (DCIS) that otherwise may never spread.

Are women simply wising up? Many (and I mean many) of the women I speak to and hear from are growing more and more leery of mammography. They’re tired of:  the radiation and squishing of their breasts; being called back for ultrasounds due to their dense breasts; and (most importantly for most) being told they must get a mammogram before the ultrasound regardless of their situation, and that insurance won’t reimburse them unless they do.

Or maybe women, after going through harsh conventional treatments, are just saying enough, and don’t want to continue screening after their experiences? Or maybe they don’t want to radiate that previously treated breast (or the healthy one) following harsh treatments because they know mammograms contain radiation which can give them future cancers?

One of the women I interviewed in the film told a horrific story about how they performed repeated mammograms to the cancerous breast after the biopsy, which only made the tumor angrier, inflaming it even more. Maybe some of the women had similar experiences and walked away thinking that Medicine had lost its common sense?

Or maybe women are starting to trade in mammography for non-radiative, non-invasive thermograms! (see previous blogs) Wouldn’t that be nice?

Specifically, MedPage said, “[a]mong breast cancer survivors ages 40 to 49, mammography rates decreased by 2.8% a year after 2009, double the rate of decline in women ages 50 to 64.” These women, as I’ve discussed in a past blog, are in the age group that has denser breast makeup (premenopausal) and therefore need a better screening tool than mammography, which misses many cancers.  So maybe their doctors are wising up and explaining this to them? Or maybe women are doing their own research on line?

Hard to know.

But whatever the answer is to the mystery surrounding what is going on with the drop in screening numbers, it will be interesting to see if anyone figures it out in the near future.

Here’s the article if you want to read it in its entirety:

https://www.medpagetoday.com/hematologyoncology/breastcancer/98112

Let me know if you hear of any other speculation out there!

Blog at you soon, thanks for reading and helping to spread the word!  (Please see the “share” links below.)  And we’d love to hear comments from you! (see below as well)

Stay healthy,

Megan

Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts

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