If you’ve been paying attention to the breast health and/or breast cancer world, you’ve noticed that recently there has been a flurry of activity around mammograms. The debate is summarized by the New York Times here, where basically the issue is that a Canadian study found that mammograms don’t, on balance, save lives from breast cancer death, though they do in fact detect more breast cancer.
Here’s the link to the actual study, which is a 25 year follow up to the original study. American entities-including the American College of Radiology are hot to discredit the studies based on all kind of issues. Probably the best critique is summed up here— she outlines why and when mammograms do and don’t work, and why she thinks the study is flawed, and what she— a breast cancer surgeon herself0 would recommend. One critiques include that the data is old, and current mammogram technology is way better than it was when the data was collected. Another critique is that if mammogram saves even one life, how could we say it was something wrong? People have written personal stories about why they never get mammograms, Ask me? Politicking.
I don’t think this is the right conversation. I think we should be talking about something else, entirely.
I think we should think long and hard about why there is no reliable breast cancer screening technique for women under 40.
I think we should think long and hard about why most of the research dollars are not going to metastatic breast cancer, which is what kills.
I think we should think long and hard about the environmental causes of breast cancer.
I think we should think long and hard about how breast cancer activism has been hijacked by companies that produce carcinogens.
So no, I don’t think the whole conversation about whether the Canadian study is methodologically sound is the right conversation. I think there are much more important conversations to be had. I think we need to think about politics, carcinogens, activism, lives. I think we need to think about why its OK to send “old mammogram machines” to the global South but not OK to use data from those same old mammogram machines in a study in the global North. I think we need to think about why no one wants to talk about the women with metastatic breast cancer, and I think we need to think about why there is no screening technique at all for younger women that is in any way reliable. Oh right, there is- MRI- but MRI is such an expensive technology it’s only available after a cancer diagnosis. That’s a win. Or a fail.
Let’s talk about some of the real issues, instead of whether or not these Canadian researchers should be slammed. I mean, really. We all know mammogram isn’t the greatest of technologies: in fact, its horribly flawed. Let’s talk about WHY that is, about the companies behind mammogram, about how Avon and Komen are wrapped in this debate, about where Chevron fits and about activism and environment and the production of plastics.
I just think this flurry of attention is entirely not what we need to talk about. It’s like incessant chatter on entirely the wrong plane.