Health News Review

Viewing false positives and ensuing anxiety as a potential harm of mammography is often scoffed at by those who promote mammography at all costs.  With a different view on that topic, here is a guest post by Mary Guiden, a communications manager and writer at the University of Washington and a former journalist who blogs at marysometimeswrites.com.

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Women are confused about mammography-related research thanks to the media. Reporters are regurgitating press releases on certain studies, which creates that confusion. The media is in the business of attracting attention, which is what led to this confusion and misinformation in the first place.

So said Dr. Martin J. Yaffe from the University of Toronto, during a June 5 Google+ Hangout on mammography sponsored by GE Healthcare. It was entitled, “Let’s Talk Mammo.” Dr. Yaffe neglected to share during the hangout that he has had multiple research collaboration agreements with and has received grants from GE Healthcare. Minor oversight.

I woke up early on that day to tune in from Seattle at 7 a.m. Pacific time. Recent studies and opinion pieces in JAMA and the New England Journal of Medicine all seemed to be saying: Let’s rethink mammography, and really talk with women about the potential harms and benefits.

I suspected that the hangout would be interesting, but was mostly flabbergasted that the docs (at least two of them) pointed fingers at the media. All of the physicians taking part were pro-mammography – not surprising, given that GE Healthcare is one of the world’s top diagnostic imaging companies.

GE Healthcare officials are quoted on the website of St. Luke’s Hospital & Health Network in Center Valley, Pennsylvania. And, yes, you guessed it, Dr. Joseph Russo, section chief of women’s imaging, was featured on this hangout. Ditto for New Jersey-based Cooper University Healthcare, whose Dr. Lydia Liao also took part and appeared to be speaking from a script.

Mammography and false positives and the related impact hit close to home for me in 2011. I ended up having a biopsy with way less than patient-centric care here in Seattle, and it was an incredibly traumatic experience. My bill was huge – I couldn’t imagine what I would have done if I didn’t have health insurance. That experience made me completely rethink the process of mammography and become even more skeptical. I’m skeptical by nature, which makes me a good reporter.

The false positive topic came up on the call. Moderator Carol Evans, president and founder of Working Mother Media said she’d heard about this from friends. “It seems like they’re unduly anxious,” she said (as if I was part of a foreign, hysterical species). “A call back isn’t something that they have to be so concerned about.”

Easy enough for her to say. It’s not particularly calming to lie face down on a table, head facing the wall and completely immobilized, with one of your breasts hanging through a hole so that someone can put a big needle in it. It’s even more jarring when you’re in that position and you hear people talking about your mammography, but not explaining anything to you about what they’re about to do.

I have a small titanium marker in my left breast and the scars from thinking I would soon be diagnosed with cancer. I suppose if I had Carol Evans by my side, I would have just calmed my anxiety and not fretted. One. Bit.

I tweeted on the day of the hangout that it would have been nice to include Dr. Joann Elmore from the University of Washington. She’s one of the leading experts on the effects of false positive mammograms on women, and I worked with her when I was on the media relations team at the University of Washington here in Seattle. Little did I know at the time that I’d fit the profile of the patient we were working with, a woman who had received notice of what turned out to be a false positive right around Christmas in 2008.

In April, Elmore and Dr. Barnett Kramer of the National Cancer Institute wrote in JAMA (as an accompaniment to the mammography study review mentioned above): “The benefit of mammography is less than once hoped and the potential harms are greater than anticipated.”  They included this about false positives: “After obtaining 100,000 mammography examinations over a decade in 10, 000 women, more than 6,000 women will be called back for additional evaluation, even though they do not have breast cancer (ie, have a false-positive result).”

Of course, GE Healthcare did not want that point of view on its hangout.

At the end of the confab, Evans shared the results of a poll that took place during the past hour. The question: Based on recent studies regarding mammography, do you plan to reduce the number you’ll have?

“100 percent of respondents said that they do not plan to reduce frequency of mammograms,” Evans said, gleefully. “I’m pleased to hear that,” said Liao.

I didn’t cast my vote.

Full disclosure: During my time at the University of Washington, I fielded media calls for Dr. Connie Lehman, who took part in the Google+ hangout. Lehman also called me when, months after my traumatic experience, I took the time to write to the Seattle Cancer Care Alliance (of which the UW is a partner) about my less-than-spectacular care experience.

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Comments

Kittykitty7555 posted on June 11, 2014 at 2:06 pm

False positives are a significant issue, no doubt about it. But the major harm of screening mammography is overdiagnosis. The continued failure of GE, the ACS and many other entities to acknowledge this fact is just execrable. Sure, throw up the red herring of false positives to try to convince everyone that screening mammo is still a great idea. But never mention that over a million US women have endured unnecessary cancer treatment that permanently changed their lives for the worse, all due to screening. Medical professionals who continue to flog screening mammo are flagrant liars. They know they are harming women and don’t care. What unspeakable ugliness.