Mammo or no? What’s best?

Dr Yousuf Ali al Mulla -

Every one of us wants a test that detects disease early so it can be treatable and hence the screening is developed.

Nowadays, mammography is used wisely as a screening modality that might help in the detection of breast cancer.

Many studies have shown how women confused by conflict of advice about the benefit and timing of the mammogram.

Parallel to that, no one needs a false alarm or results that suggest a disease when in fact no disease is present. I do believe that is the critical point as at the end such false alarms can lead to unneeded treatment or even a procedure.

We agree that mammogram is a special type of X-ray imaging used to create detailed images of the breast. One of the interesting studies done by Harvard University, has found that: women who underwent a routine screening mammogram, detected that tumours were restricted to the ducts within the breast and concluded that even without treatment would never threaten the health of the women.

What I would like to emphasise here, that the researcher here did not suggest that mammography is useless. But it was estimated that about 20 per cent of women with small tumour that could only be detected with mammogram received therapy that might be lifesaving, but the other 80 per cent of women did not benefit.

Upon reviewing such study, it is obvious that about two-thirds of reduction in breast cancer deaths in recent years are due to better treatments, not better detection.

It is not surprising that such study is controversial, and to the extent that despite such studies are new, many experts have criticised it and its conclusions, hoping that it won’t discourage women from having mammograms that could save their lives.

Especially here in Oman, the medical authority is working hard towards screening and detecting disease while it is still treatable and curable. Here I am talking about the pre-disease, not just detection.

Looking at the study and others, the conclusion is much going towards modern treatments which is important, but not solely sufficient. Women who get regular screening mammograms cut their risk of dying of breast cancer by about half.

Nowadays, screening tests for breast cancer have evolved, including a better mammogram, ultrasound and MRI, so the accuracy of diagnosis has improved.

I would say to any lady that it’s worth to have a good conversation with your doctor as no test is perfect, and sometimes we have to accept that breast cancer will be missed and false alarms could occur, even with best screening methods. Indeed, it is of merit to know the following factors which increase the risk of breast cancer like dense breast, personal history or family history of breast cancer in any first-degree relative and share it with your treating physician.

Dr Yousuf Ali Almulla, MD, Ministry of Health. He is a medical innovator and educator. For any queries regarding the content of the column, he can be contacted at: dryusufalmulla@gmail.com