Mammography saves countless women’s lives
Women of Western New York: Beware the siren song of H. Gilbert Welch. This epidemiologist from Dartmouth has finally broken through nationally with his one-man anti-mammography campaign (“We need to find a happy medium on mammography,” March 3 Viewpoints). Welch’s thesis, that the time to get a mammogram is when you have a palpable lump, in antithetical to all that we have learned over the years about breast cancer prevention.
In study after study, it has been shown beyond the shadow of a doubt that the size of a breast tumor upon discovery is a cardinal determinant of mortality. By finding and excising breast cancers still at the “baby” stage, we have cut mortality from breast malignancy very considerably over the past decades.
Recent data from the pioneering Swedish Two County trials shows a 30 percent reduction in breast cancer mortality in the screening group (ages 50 to 70) over a 29-year follow-up period, and a 25 percent reduction in those who were invited to screen at age 40, and were followed for 16 years. We are dealing here with actual longitudinal case studies, carried out universally on the population in question, and culled from many millions of monographic screenings. Welch’s “research” shows no such rigor.
The bottom line: Mammography has been a magnificent tool in our ongoing battle against breast cancer, and must remain on the front line until we have made significant advances in the prevention of this disease. Minimally invasive negative biopsies and the discovery of some non-fatal breast tumors seem to me a reasonable price to pay for stopping the all-too-prevalent killer cancers in their tracks. As a diagnostic radiologist, I am proud to make mammography a big part of my practice. It’s one of the few things that I do that actually saves lives!
Grant Golden, M.D.