The Life-Saving Power of Second Opinions for Mammograms

Key Statistics and the Importance of Early Detection

1 in 8 women, or approximately 13% of the female population in the United States, will be diagnosed with breast cancer in her lifetime. In 2024, an estimated 310,720 women will be diagnosed with invasive breast cancer, as well as 56,500 new cases of non-invasive breast cancer¹.

Chances are, you know at least one person who has been personally affected by breast cancer.

But there is hope. Approximately 66% of breast cancer cases are diagnosed at a localized stage, before cancer has spread outside of the breast, when it is easiest to treat. Today, there are currently more than 4 million breast cancer survivors in the United States².

According to the American Cancer Society, when breast cancer is detected early, and is in the localized stage, the 5 year relative survival rate is 99%. Early detection includes monthly breast self-exams and annual mammograms.

Importance of a Mammogram

A mammogram is equivalent to an x-ray that allows a qualified specialist to examine the breast tissue for any suspicious areas. According to the National Breast Cancer Foundation, women 40 and older should have mammograms every 1 or 2 years, and women who are younger than 40 with risk factors for breast cancer should ask their healthcare professional whether mammograms are advisable and how often to have them.

Many women find mammograms uncomfortable, and for good reason. Compression of the breast between two plates flattens the tissue, which is needed to obtain clear images. This compression can be uncomfortable and painful, which can deter women from schedule annual exams.

Data has shown that annual screening mammography from ages 40 to 84 years yields a mortality reduction of 40% compared to no screening at all³. Women ages 40 to 49 years who do not get screened are 3.4 times more likely to undergo a mastectomy, 4.6 times more likely to undergo axillary node dissection, and 2.5 times more likely to undergo chemotherapy, than screened women. As a result, the detection of earlier stage cancer by screening can substantially reduce the morbidity associated with breast cancer treatment⁴.

Fear Factors: A Jolt to the System

“We found something on your mammogram” can be one of the most frightening phone calls you can receive. It can trigger a cascade of emotions, including fear and confusion, followed by medical terminology that is daunting.

Many women have the instinct to act quickly, to immediately proceed with the next steps to a biopsy and treatment.

But it is important to pause and consider the accuracy of the diagnosis.

Stories of misdiagnoses are not unheard of. Mammograms, while invaluable, are not infallible. In the United States alone, it is estimated that 30% to 50% of women who participate in mammography screening will have what is called a “false-positive recall” over a 10-year period⁵. A false positive recall is when women are recalled with abnormal mammograms who, on further testing, are not found to have breast cancer at all.

False-negative results are also a fairly frequent occurrence. False negatives are when mammograms appear normal even though breast cancer is present. Overall, screening mammograms miss about 20% of breast cancers that are present at the time of screening. False-negative results can lead to delays in treatment and a false sense of security for affected women⁶.

The reasons for false positive or false negatives can depend on age, breast density, family history, ethnicity, and even the number of mammograms read by by the radiologist. Data has shown that annual reading volume requirements of 1,000 mammogams was strongly associated with achieving performance targets for nearly all measures. Increasing the minimum mammogram readong to 2,000 may further reduce the potential limitations of screening due to false positives, leading to improvements in overall breast screening program quality⁷.

For all of these reasons, second opinions for mammograms are not just an option but a crucial step for many. Seeking another perspective can potentially save your life.

Why Second Opinions in Mammography Matter

After the initial shock of a breast cancer diagnosis based on a mammogram, many women take a step toward reclaiming control over their health by seeking a second opinion.

A different radiologist might spot something the first one missed or interpret the findings differently. This is particularly crucial in ambiguous cases.

There are also advanced technologies available that improve upon mammogram results. Not all medical facilities have the same level of technology. A second opinion can lead you to a clinic that uses 3D mammography, contrast enhanced mammography, referral for a breast ultrasound or a breast MRI rather than running direclty to an invasive biopsy. Many countries have even established required quality assurance guidelines that improve the reading of mammographies and recommendations that follow as a result of a positive diagnosis off of a mammogram⁸.

A second opinion for a mammography can provide reassurance and peace of mind, ensuring that the diagnosis is as accurate as possible.

More Eyes Means More Accuracy

Mammography remains “the gold standard” for diagnosis of breast cancer. Yet studies have shown than even informal consensus meetings regarding equivocal screening cases can improve overall screening accuracy. Often times, a “double reading” keeps recall rates low without decreasing the cancer detection rate. Consensus double reading of all recalls, which required two radiologists to agree if recall was necessary, led to significant decreases in recall rate and positive predictive value without negatively affecting cancer detection rate⁹.

The more sets of eyes interpreting a mammogram, the better the chances of identifying any potential issues early.

While multiple reviews might enhance diagnostic accuracy, it’s important to remember that no process can guarantee outcomes. Being proactive and engaged in your health care is key to achieving the best possible results. Getting a second opinion is a valuable step toward taking charge of your health and ensuring another evaluation.