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Screening and Diagnosis
My mother had regular mammograms that never spotted her tumor. It was finally found via a sonogram. But it was too late. She died 90 days later. She was only 57 years old. What further evidence do we need that mammography is not enough and that all women should start demanding regular sonograms?
You are right to be angry! However, it is important that you understand what the problems are and not get side tracked into misconceptions.
Mammography is without a doubt a flawed tool. At best it has never been able to reduce death from breast cancer by more than 30 percent. There are several reasons for this. One, it does not work well in young women. Two, it cannot find all cancers. Three, and most important in your mom's case, not all cancers can be found at a point when they are curable.
New data indicates that there are about six different types of breast cancer. Each of these cancers has different types of DNA mutations. Some are so slow growing that it does not matter when you find them, they will never do anything. Others are so aggressive that it does not matter when you find them, they will probably kill you. And some are in the middle.
It is likely that your mom had the very aggressive type. We used to think aggressiveness was linked to size, but now we know that's not case. What makes a cancer aggressive is the type of abnormalities that have developed in the cancer cell. This is why someone with a small, 1 cm tumor could be dead in 90 days and another woman with a large 5 cm tumor can be cured. It has less to do with when you find the tumor and more to do with what type it is. Sadly, it is unlikely that your mom's tumor could have been found at a curable stage with any of the screening tools we now have.
This brings me to ultrasound. I don't know why your mom had the ultrasound in the first place, but generally this is a tool used to find lumps that can be felt but are not seen on mammography. When the ultrasonographer can focus in on an area where a lump has been found, she can usually find the tumor, even when it cannot be seen on mammogram.
Ultrasound does not, however, find tumors earlier, smaller, or better than mammography, a clinical breast exam, or breast self-exam. Nor does MRI. Each of these tools can only find a cancer that is already there. That is too late! I personally think the answer is getting to where breast cancer starts—in the breast ducts— and finding the cells that are just thinking about becoming cancer some day when they grow up. Finding cells this early gives us the chance to clean them out and prevent cancer from starting in the first place. Even though we talk about the importance of early detection—and it is important for many women—early detection does not keep cancer from occurring and it can't always save lives. What we need is prevention. That's why the focus of my Foundation is ending breast cancer in our lifetime through prevention.
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