Lat a mammogram? Annoying, even a little embarrassing. And then how scary, breast cancer: better not to know. So many, too many women still today do not adhere to screening, do not undergo mammograms, they pretend nothing happened. Risking discovering a tumor when it’s too late to resolve it with minimal intervention, as is possible today in the majority of cases, as long as the diagnosis is early. Everything is played on the edge of time, but Italians still struggle to understand the importance and usefulness of screening. This was demonstrated by an investigation by Umberto Veronesi Foundation Ets carried out by interviewing a thousand women throughout Italy to understand their prevention habits and knowledge of breast cancer, which is still the most widespread among women and is also increasing, with 55,700 new diagnoses in 2022.
Mammography: all the benefits of screening
The data of theNational Screening Observatory indicate that in 2021 56 percent of women took part in free screening programs with mammography, the results of the new survey confirm that many still do not take this health opportunity: 19 percent of women between 45 and 54 years old do not have never undergone a mammogram, 25 percent have never visited a breast specialist. The pandemic has slowed down checks and almost one in two, especially in the Center and South and among those under 55, say they have missed some visits and tests or have interrupted them completely, even today one in four has had them fewer.
An “inconvenience” to overcome
There However, the pandemic is not the real reason for Italians’ “disaffection” with screening for breast cancer, nor is lack of time or difficulty in organizing: what keeps women away from mammography is more often the discomfort in undergoing the exam, the fear of the result, the idea that the test is everything overall not very useful. 30 percent of younger women do not have a mammogram because they consider it annoying and embarrassing, 22 percent of over 55s prefer not to know; almost as many fear the results or believe that mammography gives false negatives, around one in ten even thinks it is harmful.
The mammogram must be done, without any ifs or buts
“Even today, too many women are not well informed about the benefits of screening” she summarizes Paolo Veronesi, president of the Umberto Veronesi Ets Foundation and director of the Division of Surgical Senology of the European Institute of Oncology in Milan. «Mammography is a slightly annoying test, but certainly no more than other tests and above all it remains fundamental.
In 2022, two million women took part in the screening and we found 10 thousand tumors that were best treated because they were identified in the early stages, but it could have been double if all those for whom screening was indicated had undergone the test. However, many continue to be afraid of the outcome of the test and prefer not to know, above all because they believe that a diagnosis means heavy surgery and chemotherapy, but this is no longer the case: screening not only saves livesin over 90 percent of tumors discovered early they can be cured with minimally invasive interventions, in day hospital or little more”.
Prevention tailored to each person
The survey also clearly shows how necessary it is to increase knowledge of screening programs and above all to improve access: women have very confused ideas on the subject, 15 percent of under 55s don’t know them at all and one in four doesn’t know what they consist of, but many also admitted that they hadn’t received an invitation to participate or had given up because the waiting lists were too long or the costs involved support to undergo the exam alone. In short, some inefficiencies must be filled.
Mammography screening: a flagship of Italian healthcare
Veronesi underlines: «The breast cancer screening program with biannual mammograms for the over 50s, which in some regions begins already after the age of 45, is a flagship of Italian healthcare. Of course, it is structured to work on large numbers and could be improved, because it is still like forty years ago, while knowledge has changed in the meantime: the PINK studio of the Veronesi Foundation on the reality of Italian breast diagnostics, for example, it is giving valuable indications to achieve personalized prevention, because it has been understood that mammography is not ideal for everyone.
To each their own prevention path
In women with a dense and therefore opaque breast on X-rays, as happens in younger women but sometimes also in those over fifty, this test is not very useful and it would be better to refer patients for an ultrasound. The objective today is to give everyone the most suitable prevention and diagnosis path to her medical history and her level of risk, subjecting each woman to the right tests and eliminating the costs of unnecessary ones. To achieve this, the ideal would be to identify your own prevention plan together with a breast specialist, who has the task of assessing the degree of individual risk.”
It all depends on individual risk
The tests to undergo and the timing with which to do so change based on the risk: women with a strong familiarity with the disease or specific genetic mutations enter into programs for people at high risk, in other cases under the age of 25 the Veronesi Foundation experts recommend breast self-examination once a month, after cycle, and at least one gynecological examination with transvaginal ultrasound. Between the ages of 25 and 40 the visit becomes annual and based on the doctor’s indications, a check-up with a breast specialist and an ultrasound of the breast can be added.
After the age of 30, 35 the ultrasound. Then the mammogram
«As a guide, we recommend an annual ultrasound for everyone after the age of 30 or 35i, because it is harmless and very simple” specifies Veronesi. «After the age of 40 it would be advisable to add a mammogram to the ultrasound, preferably annual, to which a breast examination should be associated which can also be useful for recognizing alterations that in some cases do not emerge with other tests. It is essential that women undergo screening with confidence, because it saves lives and does not compromise its quality, on the contraryi: in the not too distant future it is believed that it will be possible to avoid sentinel lymph node biopsy and surgery in tumors discovered in the early stage, which can be treated with less invasive procedures such as cryoablation. Women will be able to heal more and more often, more and more easily.”
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