Fear of pain, fear of diagnosis, lack of symptoms... Many women are anxious about having their mammogram. So much so that some even refuse to perform this exam yet strongly recommended to prevent breast cancer.
This is revealed by a poll by the League against cancer published Tuesday, September 26 on the occasion of the annual Pink October campaign. It reveals that less than one in two French women, aged 50 to 74, had their mammogram in 2022 and that 12% (more than one million women) have never even been screened.
Breast cancer affects 60,000 women on average per year and kills about 12,000 each year, according to a report by Public Health France (SpF), published on June 12. The League against Cancer also informs that 80% of breast cancers develop after 50 years and that the median age of diagnosis is 64 years. It is during this decisive age group of the disease that doctors and high medical institutions strongly invite women to be screened.
As a reminder, it is recommended for all women aged 50 to 74 to have a mammogram every two years, even if there are no symptoms or particular risk.
"Buying a good conscience"
Anne-Marie, 75, no longer has a mammogram because she does not feel concerned. "I always had the feeling that I was not at risk," says the Varoise. Like her, 34% of women surveyed do not get tested because of the lack of symptoms. The septuagenarian had however performed "two or three mammograms" at the launch of the government campaign in the early 2000s. But over the years, she decided not to do it anymore and justifies her choice: "I was little exposed to hormones, I did not take the pill for a long time and I refused hormonal treatments at the arrival of menopause".
But for Michaël Grynberg, obstetrician gynecologist and professor at the Antoine Béclère University Hospital, these arguments are only a way to "buy a good conscience" and are part of a "lack of information" on the subject. "Many studies establish that hormones, such as those in the pill, are not linked to breast cancer," he informs before adding that "pills can evenprevent certain cancers such as ovarian cancers."
Anne-Marie also explains her choice by the fact that when she was 20 years old in the 1970s, "few people hadbreast cancerunlike today". According to SpF, incidence rates doubled between 1990 and 2018, from 29,970 to 58,400 annual cases, or +1.1% per year on average. This is explained by "the implementation of mass screening of the disease", contextualizes Michaël Grynberg who recalls that we "cure better and better, precisely thanks to screening". Because detected early, breast cancer is cured in 90% of cases, informs the League against cancer.
'It's a shame'
But some keep in mind only the pain caused by this examination. "It is barbaric and extremely painful," denounces Christelle. 20% of the women surveyed also agree. "This summer, I asked the radiologist to stop everything because I could not stand the pain anymore," she says before adding: "I understand that some women do not do the exam because of this."
Sophie* would like to be tested but deplores a lack of appointments available to do so. "I've been fighting for two years to have an appointment, confides the Breton. I did all the medical centers 150 kilometers around. And nothing. It's a shame." As soon as they are put online, appointments are "quickly booked", she is angry. In the absence of a solution, she "seriously thinks of taking advantage of a family visit to Burgundy to make an appointment in Nevers". The League's survey informs that for 10% of French women surveyed, screening centers are simply too far from home.
Far from fighting to get an appointment to do the exam, Stephanie simply thinks that screening campaigns "are useless". 11% of women surveyed share this opinion. According to the 54-year-old, mammography reminder letters sent by Social Security to all women from the age of 50 are an "unnecessary expense."
Fear of rays
Stephanie has refused to take the exam for more than seven years. It is justified by a reason that does not appear in the survey: the fear of the rays emitted by the mammography machine. "I have read a lot of studies and scientific articles that talk about the risks of developing cancer, precisely through mammography," she says.
Breast tissue is radiosensitive, agrees Michaël Grynberg. However, the balance of benefits and risks has been assessed." Getting a mammogram becomes dangerous only when "you start doing it at age 20 and every year. Studies show an increase in radiation-induced cancers when women do them at will," says the gynecologist.
Concerned about this slight risk, Stéphanie prefers "self-examinations". "Before, this practice was learned from generation to generation," laments the fifty-year-old. She therefore chose to continue this tradition with her daughters. "Self-examination is the first means of screening," says Michaël Grynberg. But it remains an archaic practice that does not detect stages of cancer too late." Thus, the gynecologist recalls that screening by mammography remains the best solution to detect the disease as early as possible.
*First name has been changed.