• A new study finds skipping one scheduled mammogram can greatly increase a person’s risk of death.
  • During the COVID-19 pandemic many people fell behind on regular mammograms due to access or concern about COVID-19.
  • Experts say if you missed a scheduled mammogram now is a good time to get screened.

We are seeing a light at the end of the COVID-19 pandemic tunnel, but experts are quick to remind the public that COVID-19 is far from over.

For many the last year has meant staying home as much as possible and sometimes skipping regular health checks.

But experts say remaining vigilant does not mean postponing regular health checks, particularly cancer screenings, and mammograms for women. Now a new study finds women who skip even one scheduled mammogram screening before a breast cancer diagnosis can face a significantly higher risk of death.

What the study found

The study, which was published in the journal Radiology, looked at data from nearly 550,000 women eligible for mammography screening in Sweden from 1992 to 2016. Women were divided into groups based on participation in the two most recent scheduled screening exams prior to a cancer diagnosis. The data showed that those who participated in the two most recent screenings had a higher protection against the cancer.

Fatality within 10 years of diagnosis was 50 percent lower for these participants. Compared to women who attended only one screening, women who attended both had about a 30 percent reduction in breast cancer mortality.

“This study shows that 50 percent of women died from their breast cancer if they did not have routine screening mammograms than women who had routine screening mammograms. This is a big number,” said Dr. Kristin Byrne, Chief of Breast Imaging, Lenox Hill Hospital, New York. “Routine screening mammography gives patients the best chance to discover a small invasive cancer before it has spread to other parts of the body. This is why it is so important for women to get their screening mammograms every single year and not just some years.”

Dr. Alice Police, Westchester regional director of breast surgery, Northwell Health Cancer Institute, said this study helped answer the question of does skipping just one or two mammograms “really matter?”

“This direct link between missing a mammogram and breast cancer death has been largely missing from screening research,” Police said. “This important study emphasizes the power of screening mammography to reduce the mortality rate from breast cancer and to improve the lives of women.”

Mammograms during the pandemic

That said, 2020 was a very different kind of year. Many hospitals had to put cancer screenings and other medical procedures on pause as they were inundated with COVID-19 patients.

Additionally some people scheduled for cancer screenings may have been hesitant to get screened even if these options were available to them in the midst of a pandemic.

One study done in July 2020 at Massachusetts General Hospital showed that 22 percent of respondents had a delay in breast cancer screening. More than 31 percent of people who had been diagnosed with breast cancer reported a delay in care, and 9.3 percent reported a delay in treatment. 

Early detection is essential in reducing the risk of death from breast cancer.

The American Cancer Society predicts that this year there will be more than 281,000 new cases of invasive breast cancer diagnosed in women. About 49,000 new cases of carcinoma in situ (CIS), a non-invasive and early form of breast cancer, will be diagnosed. More than 44,000 deaths from breast cancer are expected to occur in 2021.

What can we do now?

Experts and medical professionals want to get the word out to women that it is imperative to continue with your regularly scheduled mammograms — and that doctors’ offices and hospitals are better equipped than ever to keep patients safe from COVID-19. 

“For primary care physicians, clinicians, and providers, get the word out,” said Dr. Vivian Bea, Chief of Breast Surgical Oncology at NewYork-Presbyterian Brooklyn Methodist Hospital and assistant professor of surgery at Weill Cornell Medicine. “Encourage their patients to not skip that mammogram.”

She adds that people should still stay vigilant and within the COVID-19 regulations when going to get screened. This means wearing a mask, using hand sanitizer, and staying socially distant.

“At New York Presbyterian, we’ve made changes to decrease the risk of transmission for COVID. One or two patients are scheduled at the same time. They are six feet apart in the waiting area. The equipment is wiped down, and the staff and faculty has the appropriate PPE to decrease transmission,” Bea added.

Hospitals and doctors’ facilities all over the country are safe and taking heightened precautions.

If you are at all concerned, call your preferred institution and ask questions about what safety measures have been taken.

The one caveat, Bea warns, is that many hospitals and doctors’ offices are still overwhelmed with appointments because they are catching up on all the delayed mammograms, so it is important to be diligent in trying to set up that screening.

She also brings up the point that the pandemic affected many women’s insurance.

If women lost their jobs due to the pandemic, they may have lost their health insurance, which could be impacting whether or not they get a mammogram.

Bea recommends looking into federal and statewide programs that cover mammograms in certain states.

“If we engage the community and help them upfront with what they’re concerned about, we delay any fears. I encourage any community leaders to help get the word out that women need their mammograms,” she said. “I really believe this is an effort that has to be pushed forward. Breast cancer didn’t stop because COVID-19 appeared. Breast cancer isn’t going to stop.” 


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