5 Surprising Facts You Didn’t Know About Mammograms

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5 Surprising Facts You Didn't Know About Mammograms

Many women view mammography as the ultimate preventative measure against breast cancer. The thought of not complying with the routine examination is considered an utterly irresponsible behavior. But should mammograms really be the done thing or should we question and scrutinize them?

More and more research is showing that the use of mammography in otherwise healthy women with no symptoms is controversial. There is an ongoing discussion about the risks versus benefits of this procedure. Before you have your next (or first) mammography, make sure you get informed and don’t just go along with the medical establishment.


About mammography

If you ever had one, you know it’s not a particularly pleasant examination. The breast gets compressed inside a mammography unit and low energy X-rays are used to examine the tissue. The goal of the procedure is to detect early breast cancer and other (potentially) pre-cancerous masses.

In most Western countries, women with an average risk of breast cancer get routinely screened using mammography from the age of 50, and the checks are done every second year. The American Cancer Society recommends more frequent examinations: annual mammograms starting already at the age of 40.

However, the Swiss Medical Board recently decided to stop with systematic mammography altogether due to lack of evidence about its benefits.

Clearly, there is no consensus on the topic, which makes the decision-making process even harder, and clinicians and women are often faced with a dilemma.

A Large Study Doubts The Benefits Of Mammograms

In February 2014, a Canadian study that shook the breast cancer industry was published in the prominent British Medical Journal (BMJ). It compared breast cancer incidence and mortality over a period of 25 years in women aged 40 to 59 who did or did not undergo mammography screening. Women who did not receive mammography had an annual physical breast examination. Almost 90,000 women were included and the study is considered one of the largest and longest on this topic to date.

During the entire study period, 3250 women in the mammography group and 3133 in the control group received a diagnosis of breast cancer. 500 and 505, respectively, died of breast cancer. This showed that death from breast cancer was very similar between the two groups and was not influenced by the presence of mammogram.

The authors of the study concluded:

Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care.


Moreover, the study showed that 22% of women in the mammography group were over-diagnosed. This resulted in one in 424 women from that group of participants receiving unnecessary cancer treatment, including surgery, chemotherapy and radiation.

5 Points About Mammography You Should Consider

1. Mammograms might not be as beneficial as you think

Many women completely trust their mammography. The procedure might be able to save your life, but the success rate is not as high as we would wish. Mammography offers (at best) a risk reduction of about 20 to 25%. This is not negligible, but when we look at the absolute death prevention numbers, the screening itself prevents only one breast-cancer death in 1,000 women.

Studies that found mammograms helpful were mostly done some time ago and did not comply with the strict scientific rigor. Furthermore, Dr. Mette Kalager, an epidemiologist and screening researcher at the University of Oslo and the Harvard School of Public Health, explains that these days early breast cancer detection is somewhat less important as better treatments are available. According to many experts, it is the accessibility of drugs like tamoxifen that has reduced breast cancer mortality, and mammography plays a much lesser role.


2. Mammography can increase the risk of breast cancer in women with a specific gene mutation

Women who carry a specific gene mutation called BRCA 1/2 are more vulnerable to radiation exposure from mammography. This gene mutation is linked to cancer development. According to the BMJ study, women with this gene who received a dose of diagnostic radiation before they were 30 were twice as likely to develop breast cancer compared to their peers who did not undergo screening. The greater the dose of radiation, the more likely it was for the cancer to occur.

Generally speaking, mammography will expose you to a certain dose of radiation and there are mixed opinions about the dangers of that. While some argue that modern-day mammography involves a tiny amount of radiation, others are more cautious and warn that the radiation might be particularly dangerous to younger women.

 3. False positives are common

No screening exam is definitive and one of the challenges of mammography lies in giving the patient a diagnosis that is false. If you are told you possibly have a breast cancer, this will of course result in a considerable amount of psychological stress and anxiety. You will be referred for further testing, which comes with its own risks.


Also, according to a study published in 2014 in Cancer Epidemiology, women who receive a false-positive result are more likely to develop cancer later. The excess risk is not fully explained yet.

4. False negatives cannot be avoided

There are also numerous cases where cancerous and pre-cancerous growths get missed. It’s difficult to spot suspicious masses if your breasts are dense. 50% of women have dense breast tissue, which appears white on an X-ray image. But cancer, too, appears white, which makes it extremely difficult to see the difference. Patients with dense breast tissue should be aware that mammography is of much less use to them.

 5. There are other screening options

Normally, many women are very worried when it comes to their breast health and want to do what is best for them. Bear in mind that there are other screening options, and the only test that can confirm cancer is biopsy. An ultrasound or MRI might be better suited for certain women, and you have the right to explore these possibilities or use them together with mammography.

Every woman should be aware of the breast cancer signs but did you know that there are 5 unconventional signs of breast cancer? You can read about them in my article about 5 unconventional signs of breast cancer you didn’t know about.

There are certain type of foods that may reduce the risk for developing breast cancer and I wrote about these foods in my article about the best 7 foods for breast cancer prevention.

Another interesting article you may wish to read is about breast cancer and bras: breast cancer and bras – is it time to ditch your bra?

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11 Responses to 5 Surprising Facts You Didn’t Know About Mammograms

  1. Anna Estabrook says:

    Dear Jenny,
    I appreciate the information on mammograms you posted and am glad that I came across it. I have some follow-up questions about #2, as I’ve been looking into the study you cited (in BMJ). I’m referring specifically to these lines: “According to the BMJ study, women with this gene who received a dose of diagnostic radiation before they were 30 were twice as likely to develop breast cancer compared to their peers who did not undergo screening. The greater the dose of radiation, the more likely it was for the cancer to occur.”

    I read the study and didn’t find anything about BRCA 1/2, but wonder if I missed something or perhaps you accidentally cited it wrong. Would you be willing to look into this and let me know what you find? I’m trying to decide myself if I should get a mammogram (which is what doctors are telling me I should do), but that statement and the fact that Switzerland has decided to do away with regular screenings with mammogram. I’m 28 years old and have BRCA 2.

    Thank you for getting back to me soon!


  2. Vivienne says:

    I went for infrared red camera test! Painless and can detect Brest cancer up to 10 years before he signs show!

  3. Ann says:

    Hi Jenny,
    Thanks for the information,,I guess I need to skip my mammogram next year,I’ve done it yearly due to my atypical condition,beside they discover this tru ultrasound not by mammography,,

  4. j john says:

    mammogram saved my sisters life

  5. Susan Tedrahn says:

    Question. I had a mammogram a couple of months ago.A 6mm growth was found in my left breast. An ultrasound was recommended, so I had one. It came back inconclusive and recommended a more intensive mammogram I am not having any signs or symptoms. Cannot feel a lump. I do have dense breasts AND I do have saline breast implants that have failed and need to be removed. AND I am 69 yrs. old AND I am hesitant about having additional X-RAY exposure. What are your thoughts?

    • Jenny says:

      Hi Susan, you must remember that I’m not a doctor or a certified health practitioner. I have several thoughts that I can share with you, and with them in mind, you will be able to refer back to the specialist with more questions so you will be able to make a more informed decision.
      1. You’ve said that your breast implants need to be removed. I am thinking if there is a possibility to do the implant removal procedure relatively soon and take a biopsy of the growth for further analysis. I don’t know if it’s possible or recommended, but it’s something to think about and discuss with the specialist.
      2. Another thought: generally speaking ultrasound is better for younger women who usually have dense breast tissue (read this study about comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density). However every person is different, and there might be a case of an older woman who still has dense breasts. You said you have dense breast despite your age. I’m not sure what exactly is “more intensive mammogram”. Since you have a dense breast, I would have imagined that ultrasound will give better results as per the study. I’ve heard that there is film-screen mammography and digital mammography and that the second type is mainly suitable for women who have have dense breast tissue, but I’m not an expert in radiology and screening techniques so I would find out more about the “intensive mammogram” and in what exactly it differs from regular mammogram or an ultrasound.
      3. I’ve heard about another screening method called thermography that does not involve radiation. This is not a stand-alone method but an adjunctive imaging test. Perhaps it worth asking you specialist if this method (in conjunction with the other methods) is something to consider.
      4. It is important to find out what type of growth you have in your breast despite not feeling any signs and symptoms. If you don’t find the answers or clarifications that you are looking for from your current specialist, you can always opt for a second opinion.

  6. Brittany Powley says:

    I am 27 years old. I was diagnosed with Stage 3 Melanoma last year. June 10 was my last day! But my dermatologist had felt a lump around the armpit/breast area. She wanted me to get checked. Right breast has pain. I had an ultrasound done on it it came back fine. So I told my oncologist that I want a mammogram done and showed him pictures of my left breast. It’s dimpling like an orange. He said I needed to get one ASAP. So Friday I went in for my mammogram. They wanted an ultrasound done right after. I feel like I didn’t get any answers. So my official results from my oncologist I’ll get on Tuesday. This hospital is also known for false outcomes.

    • Jenny Hills says:

      It is indeed stressful for any person. There can be false results in any type of scanning, and this is why they often combine 2 different methods (such as ultrasound, mammograms, MRI). I hope it all goes well for you and that there is nothing serious.

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