An Oklahoma mayor underwent a 3D mammogram (tomosynthesis) as part of a hospital promotion. She was diagnosed with ductal carcinoma in-situ (DCIS, also known as Stage 0 breast cancer) and she stated that the study “…saved my life.” She also recommended that women make sure to obtain a 3D mammogram. The story noted that tomosynthesis “virtually eliminates” the need for additional testing, and that early detection makes it less likely that the patient will need to undergo chemotherapy or radiation.
Here are a few errors in the story:
Statement: the mammogram saved my life
Fact: survival from breast cancer depends on many factors. The survival rate for patients with DCIS, regardless of treatment, is close to 97%. For invasive cancers, survival rates depend on stage as well as tumor biology. Small breast cancers “caught early” can still be lethal. It’s not the cancer in the breast that kills, it’s the cancer that gets to other areas of the body. Small tumors can and do spread.
Statement: early detection makes it less likely that a patient will need chemotherapy
Fact: the need for chemotherapy depends on tumor stage as well as tumor biology. As noted above, some very small, early stage breast cancers are very aggressive and have a high likelihood of spread, so chemotherapy is recommended. This is especially true for “triple negative” and “Her2/neu over-expressed” breast cancer subtypes.
Statement: early detection makes it less likely that a patient will need radiation therapy
Fact: radiation therapy is a standard recommendation for women with early stage breast cancer who undergo a lumpectomy. Since most women with early stage breast cancer are candidates for a lumpectomy, this statement simply doesn’t make any sense.
Statement: tomosynthesis “virtually eliminates” the need for additional imaging
Fact: while tomosynthesis can reduce the likelihood of needing additional views (“callback”) especially in women with dense breast tissue, diagnostic imaging with possible biopsy are still recommended when a concerning abnormality is seen.
While I certainly wish Ms. Noble well, stories like this always make me cringe, because they over-simplify a very complex situation. Here are some posts from Health News Review with some additional information:
Mayor: 3D Mammogram Saved My Life
3D Mammography and False Hope
