Mammograms and the Detection of Benign Tumors

I recently came across an article that was discussing the effects on women when mammograms detected benign cancers. I must say that I didn’t know that there was such a thing as a “benign cancer”. I thought that it was either a benign tumor or cancer but the article makes it clear that there are cancers “that would never have presented clinically, or caused a woman harm, during her lifetime”. The article further indicates, “receiving treatments for these benign cancers could harm women physically and emotionally with radiotherapy increasing risk of heart disease and the diagnosis causing psychological distress”. I completely understand and agree with this summary but what I don’t understand is why I have never heard of anyone being diagnosed with benign cancer.

“I recently came across an article that was discussing the effects on women when mammograms detected benign cancers. I must say that I didn’t know that there was such a thing as a “benign cancer”.Barbara Jacoby

Further, the article indicates, “… that for every one woman diagnosed with breast cancer, three will be overdiagnosed and overtreated, whether through surgery, radiation or hormone replacement therapy”. This is absolutely astounding to me and results in my having more questions than answers at this moment. And even after additional research I haven’t been able to find any real answers to why this is happening.

It appears that when a mass is detected and it is biopsied, it is determined at that point whether it is cancerous or not. If it is determined to be cancer, the decision is made at that point to remove it. It seems that such a determination is made in order to err on the side of caution. To make a determination whether a particular cancer is lethal or benign is often only made after the tumor has been removed.

Apparently the reason that such over-diagnosis and over-treatment occurs is because doctors can’t always predict which cancers will spread and become harmful and which ones will not. Under such circumstances, I do understand why a doctor would not want to take on the responsibility. Perhaps this is the reason why some doctors advise a patient to wait on taking aggressive action immediately and monitor the mass/tumor/cancer that has been discovered. However, it seems to me that many doctors unilaterally decide that if it is cancer then it should be removed and never give it another thought.

As outlined in this article, I, too, believe that women should be provided with all of the information about their particular situation and be allowed to make an informed decision. Even if they would make the exact same decision as the doctor, empowering them to know the facts and make their own choice provides a certain sense of control in a situation in which they do not have any other controls or choices. The patients have the right to know the reality of their own personal situations. This is the immediate answer for this situation.

However, there is one extremely large factor that is getting overlooked in this discussion and that is the inability to determine whether a particular cancer is likely to be harmful or will never become harmful. With so much time and money and effort being spent on research regarding all matters regarding breast cancer, is anyone looking at finding a test that would determine whether any cancer that is found is one that will ultimately become harmful? If, for every one woman diagnosed with breast cancer, there will be three over-diagnosed and over-treated, shouldn’t this have been a focus before now to develop a test to make this determination before a woman has to undergo the physical and mental trauma when it may not be necessary? It seems that rather than focusing on the women who are diagnosed with cancer, the emphasis has been placed on the medicine and science to protect a possible misdiagnosis. While this may seem to be perfectly logical, it will never make up for all of the women who have had or will have their lives changed forever because of a diagnosis of breast cancer that would never have been a threat to them in this lifetime.