The answer to this question is yes for many reasons. Let’s go though some examples that are relevant to most women:
Screening for cervical cancer is no longer recommended in a woman who is younger than age 21. Additionally, a woman with a normal pap and/or a negative high-risk human papilloma virus (HPV) test can wait 3-5 years before the next Pap smear.
Also women with average risk for cervical cancer do not need a pelvic exam when they have received regular Pap smear exams.
The Clinical Breast Exam
In average risk women with no breast symptoms, a breast exam is not helpful and only produces false positives which can lead to unnecessary biopsies. So if an average risk woman gets regular mammograms a breast exam is not useful and superfluous.
Dense Breasts and Further Testing
There are laws in some states that require notification by mammography centers if a woman has dense breasts. It is possible that such laws will eventually go nationwide. Certainly these laws have good intentions but our knowledge base has not caught up to the regulations.
Often women with dense breasts receive additional imaging such as ultrasounds and MRIs. But all we know is that such additional testing leads to more biopsies and false positives.
But there is a more important question to answer. Does additional testing actually lead to better outcomes? Unfortunately, the answer to this question remains unknown.
Costly tests that lead to unnecessary painful procedures must not be done until we have the answers. Some women will want the extra testing but practitioners should counsel women about what we know and what we don’t know.
Avoid unnecessary testing and be aware of the facts. Additionally, there are a few unscrupulous health care providers who do unnecessary pelvic and breast exams.
Specialists outside of OB Gyne and surgery have done unnecessary pelvic and breast exams which is a travesty. Such health care providers should be reported to the Department of Professional Regulation.
Be aware of these guidelines and take care your body and protect it as well.
Evan L Lipkis MD