Readers React: Cancer survivors: If we had followed new mammogram guidelines, we might not be alive

To the editor: Last week I took the first of 1,826 tablets, the beginning of a five-year daily adjuvant therapy following my breast cancer surgery in September. When I finish taking this medicine, I’ll be 90 years old. I am very fortunate. (“American Cancer Society abandons ‘one size fits all’ advice on mammograms,” Oct. 20)

I don’t care that the American Cancer Society has changed its mind about the need for clinical breast exams or on the ideal starting age for screening mammograms. I’m just thankful my current doctor authorized a mammogram for me in July. Previously, because the U.S. Preventive Services Task Force recommends biennial breast screens only through age 74, my doctor in 2012 had refused my request for another annual screening. I was deemed part of a disposable segment of society — not worth the cost of a mammogram.

Please, ladies, regardless of when you begin having mammograms, insist on continuing them, at least every other year. The risk of breast cancer increases with age. Because 14% of breast carcinomas occur after age 80, ignore the U.S. Preventive Services Task Force conclusion that the current evidence is insufficient to assess the benefits of screening mammography in women 75 years and older. Get those mammograms; I know, they can be uncomfortable (gentlemen, imagine having your tender parts squished to what feels like the thickness of a cheap paper plate). But the alternative could be missing a tumor that metastasizes into organs and bones.

It’s a good trade-off for a few minutes of discomfort and the price of a family dinner in a good restaurant. I hope that anyone with an elderly female relative will lobby on her behalf for the early preventive detection she deserves.

Patricia S. Jones, Hermosa Beach

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To the editor: The American Cancer Society is now advocating tailored breast screening, not a one-size-fits-all approach to mammograms. The Cancer Society and The Times’ reporting fail to mention one of the biggest reasons one size does not fit all: breast density.

This is a much bigger story, with a much larger public health impact than the revised guidelines for mammograms.

Women with dense breasts account for about 40% of the population. For these women, mammograms are next to useless because the density of their breasts prevents radiologists from seeing tumors. They need ultrasounds or MRIs to detect breast cancer. Breast density is also a risk factor in and of itself for breast cancer.

California now has a law (along with more than 20 other states) requiring radiologists to notify women with dense breasts of the limitations of mammograms in detecting cancer in their breasts.

So the advice that the Cancer Society should be giving to all women is this: Find out if you have dense breasts. If you do, have your doctor request an ultrasound or MRI. And don’t wait until you are 55 to do so.

Alexandra Jaffe, Lakewood

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To the editor: I was in good health 11 years ago and had no reason to suspect my risk of developing breast cancer was above average. My yearly mammogram revealed an aggressive tumor, allowing a treatment plan for me to be cancer-free today.

If I had followed the recent guidelines of the American Cancer Society, I undoubtedly would not have survived.

Certainly my case is anecdotal, yet I do not fear false positives nor anxiety used to substantiate their findings. For me, the benefits of early detection far outweighed my fear of overtreatment. Just ask my children.

Robin Clough, Santa Clarita

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