Feature Article:::...

Mammograms detect, do not cause breast cancer

By: Wendy H. Vogel, M.S.N., F.N.P., AOCNP

October is Breast Cancer Awareness Month. This year, there will be more than 194,000 new cases of breast cancer diagnosed and about 40,600 deaths from the disease.

During this month, you will have heard a lot of encouragement for women to get a mammogram. Mammograms are recommended for breast cancer screenings beginning at age 40 and continuing yearly. Younger women who are at higher risk for breast cancer may also need yearly mammograms.

Breast cancer is a frightening disease, and because of this, many myths exist about its cause.

Have you heard the myth that claims mammograms can actually cause cancer?

THE MYTH: For several years, some people have claimed that 75 percent of all breast cancers could be avoided if women did not get mammograms.

The so-called theory behind this myth is that ionizing radiation used to visualize breast tissue is great enough to cause sensitive cellular DNA in the breast to mutate, causing a cancer.

In addition, some claim that the pressure from compressing the breast for the exam could also cause cancer cells to spread. It has even been suggested that the wicked “medical establishment” has “brainwashed” us into allowing ourselves to be “criminally assaulted” by this “medieval torture” for its own financial gain.

THE TRUTH: A mammogram is an X-ray of the breast used to look for breast cancer that is too small to find by a breast exam. Mammograms have been used for more than 90 years.

An X-ray machine sends a type of electromagnetic radiation through the body. Some of the radiation comes out on the other side of the body, where it exposes film or is absorbed by a digital detector to create an image.

It is true that some of this radiation is absorbed in our body tissues. But how much is too much? How much can cause more harm than good?

We are exposed to naturally occurring radiation daily. The yearly dose we are exposed to naturally is about 3 millisievert (mSv). A mammogram gives us about 0.7 mSV or what we would typically be exposed to during about 3 months in our own back yards. This low level of radiation is determined safe by the American College of Radiology (ACR).

It would take 100 to 1,000 times these radiation doses to show any statistical increase in the occurrence of breast cancer. The ACR created the Mammography Quality Standards Act that was passed by Congress in 1992 that mandates strict guidelines for X-ray safety during mammography.

The radiation exposure of mammography is so small, that the benefits far outweigh the risks. Mammograms are the most accurate way of detecting breast cancer and find about 80 percent to 90 percent of breast cancers. (No test is 100 percent effective.)

While mammograms do not PREVENT breast cancer, they can detect a cancer at its earliest stage while it is still curable. A mammogram may find a breast cancer as much as a year or two before you or your health-care provider could feel it.

If a breast cancer is found in a localized stage, there is a 98 percent five-year survival rate. However, if a breast cancer is found in the last stage (when it has metastasized), there is only about a 23 percent survival rate at five years.

In addition to mammography, women should also have breast exams performed by their health-care provider yearly. Self-breast exam done monthly can also help detect a breast cancer early.

What about the danger of compressing the breasts? There is no evidence that any type of injury, including compression will cause a cancer to occur or to spread.

And what about digital mammography — is it safer? Both regular mammography and digital mammography use X-rays to evaluate the breast, but digital mammography stores the electronic image on a computer and regular mammography stores it on film — like the difference between a digital camera and film camera.

The advantage of digital mammography is that subtle differences may be digitally noted more easily and fewer follow-up images might be needed, thus lessening the total radiation exposure.

So the bottom line, “stay abreast” of the truth in order to “keep a breast.” Do your self-breast exams, see your health-care provider for clinical breast exams, and if you are 40 or older — get your mammogram ... and worry about something else!

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Wendy H. Vogel, M.S.N., F.N.P., AOCNP, is an oncology nurse practitioner with Kingsport Hematology/Oncology Associates in Kingsport.