Mammograms can help--and harm

“Mammograms can help–and harm.” By H. Gilbert Welch, CNN.

As part of breast cancer awareness month, a 40-year-old anchor had her first mammogram on morning television. And last week the anchor, Amy Robach, underwent a double mastectomy after announcing she had cancer, and saying — in front of 5 million viewers — that “having a mammogram saved my life.” And I feel the obligation to point out that other possibilities are more likely. 

To understand why, you need to know how doctors now think about cancer: in terms of turtles, rabbits and birds. The goal is not to let any of the animals escape the barnyard pen to become deadly. But the turtles aren’t going anywhere anyway. They are the indolent, nonlethal cancers. The rabbits are ready to hop out at any time. They are the potentially lethal cancers, cancers that might be stopped by early detection and treatment. Then there are the birds. Quite simply, they are already gone. They are the most aggressive cancers, the ones that have already spread by the time they are detectable, the ones that are beyond cure.

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