Pictures of Health

When that ACOG survey asked women what kept them from getting the recommended mammogram and Pap smear screenings, two-thirds said they believed—mistakenly—that if they had no family history they faced little risk. Another 18 percent said they thought the tests were unnecessary, and 7 percent said the screenings were a “waste of time.”

Though he obviously disagrees, Jonathan Slater, director of the Minnesota Department of Health’s Cancer Control Section, says he can understand why many women—with crowded kitchen bulletin boards of their own—might come to such conclusions. “Who wants a mammogram?” he says. “In the best of cases, you go to all of that trouble, inconvenience, and discomfort and find out it was for nothing. Or, in the worst cases, you find out it’s what no one wants to hear.”

According to Tim Emory, director of breast imaging at the University of Minnesota Medical Center, Fairview, a thousand screening mammograms will typically result in fifty to a hundred women being asked to return for additional “screening call-backs.” Of that group, ten to fifteen may need a biopsy, and five of them—or half a percent of the original screening group—may learn they have breast cancer.

“Lack of time is one of the justifications given [for not getting screened], but often the underlying reason is fear,” Slater says. “But these are the psychological barriers that have to be overcome if you want to live a long and healthy life.”

Fortunately, a majority of Minnesota women over the age of forty seem to be clearing that hurdle. In 2006, almost seven out of ten had a mammogram in the previous year and eight of ten had one in the previous two years—which makes for one of the highest mammogram screening rates in the country. Some of the credit goes to the Sage Screening Program, a comprehensive breast and cervical cancer initiative concentrated on women who are uninsured or underinsured and is funded by the state, the U.S. Centers for Disease Control and Prevention, and money raised by the Twin Cities Race for the Cure.

Though demand for screenings is up 12 percent over the previous year, with more than 17,000 free mammograms offered through the program, Shelly Madigan, former Sage director and now section manager of MDH’s Cancer Control Section, says she still encounters women who aren’t sure they want to know what a screening might tell them. “I don’t have time to have breast cancer,” women frequently tell her.

Madigan understands the sentiment; she received her own breast cancer diagnosis in 2001. “It was a total surprise to me as it is to many women,” she explains. “I was a single mother with no time either and all of a sudden you’re put into a treatment schedule that takes over your life.”

Madigan’s diagnosis might have come earlier had she gotten a mammogram every year—the current recommendation for women over forty. But following the prevailing advice at the time—that women with no family history get screened only every couple of years—she and her doctor decided to wait. “I really regret not having that annual mammogram, because my cancer would have been smaller and I probably wouldn’t have had to go through everything I went through,” she says, adding that she has since learned, through her brother’s genealogical research, that breast cancer has been in her family. “It just skipped two generations.”

As for women who think they don’t have time to get a mammogram, Madigan says the time they save now may steal from the time they have left.