Arguments over mammography are all over the media the week – again. I spent much of the past few days listening and watching all the media coverage and scanning newspaper articles, while answering emails from confused young women from our support programs.
The Canadian Task Force on Preventive Health is recommending the average woman in her forties not bother with mammograms.
The Canadian Cancer Society supports the guidelines. The Canadian Breast Cancer Foundation disagrees insisting that women in their forties should receive regular mammograms.
Where does Rethink Breast Cancer stand?
Frankly, I am frustrated to see mammography screening guidelines yet again being turned into a controversy. It's causing further confusion and, frankly, distracting from more glaring issues. I think all this fighting over mammograms is a great way to bury our heads in the sand and avoid facing the reality that not enough progress is being made in ending breast cancer. After decades of fighting breast cancer, we still don’t know why it happens.
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| MJ DeCoteau |
Rethink Breast Cancer has spent 10 years working to change the face of breast cancer; to show that young women get breast cancer too. We also advocate for and run support programs for young women dealing with breast cancer.
Because of our focus on young women, there may be an assumption that Rethink Breast Cancer would vehemently oppose the new guidelines. However, we actually are quite comfortable with them! We support a movement towards more personalized screening and informed decision making.
The new guidelines aren’t preventing women under 50 from having a mammogram, which seems to be what the critics of the guidelines want the public to think. Any Canadian woman can have a free mammogram; it’s just that women under 50 need to have a conversation with their doctor first to get the referral. It’s about helping women make an informed, personalized decision instead of one size fits all solution.
Personally, I wish all this time, energy and money spent advocating to expand mammography screening (a tool with many shortcomings) could be re-directed into a push for better and more efficient screening tools instead!
To paraphrase breast cancer survivor Fran Visco, a long-time, renown breast cancer advocate in the US:
…there is comfort in arguing over mammograms. It's been a decades long debate. We cling to our emotions around mammograms, no matter what the evidence tells us. It’s hard to challenge long-held beliefs but it’s about time. Let's push for new and more efficient tools!
The task force also recommended not to perform clinical or formal breast exams. As our Your Man Reminder App proves, Rethink is committed to encouraging women to know their bodies and be breast aware. We have never pushed a formal ‘breast self exam’ technique and there’s no evidence that you need a specific technique. A lot of money went into creating complicated fold out pamphlets on breast self exams and having public health nurses teaching them – money that can be better spent. What’s important is for women to know their bodies and report changes to a medical practitioner.
In addition to pushing for more efficient screening tools, we need to continue to push for a better understanding of causes and prevention too. Our organization continues to see far too many young women in our support programs and far too many young women die from advanced breast cancer. Despite the emphasis in Canada and the US on early detection of breast cancer through mammography and breast self-examination, the incidence of women diagnosed with advanced breast cancer has not really changed since the 1970s. That's not acceptable. It's time to challenge the status quo.
MJ DeCoteau
Executive Director
Rethink Breast Cancer
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