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Sunday 23rd October 2016

Debate over mammogram screening

11th December 2012


Recent studies have prompted further public debate over the benefits of mammograms for the screening of breast cancer.


According to a study published in November, as many as one million American women may have been treated for breast growths that were not a threat to their health or their lives.

Current medical advice indicates that women over the age of 40 should seek mammogram screening every year, based on the belief that doing so could save their lives.

But the recent study, published in the New England Journal of Medicine shows that the mammogram is simply not very efficient at picking up the deadliest forms of cancer, only least aggressive one.

Mammograms are widely agreed to be useful once a woman has already been diagnosed with breast cancer.

But they have effect on mortality rates among women with breast cancer, according to eight trials performed in the United States, Canada and Europe.

Those trials evaluated the ability of screening mammograms to decrease the death rate from breast cancer, as well as overall mortality. 

The latest study builds on the analysis of previous trials carried out by the Cochrane Collaboration, which found no evidence that screening mammography reduces deaths in women with breast cancer.

Co-authors Archie Bleyer and Gilbert Welch concluded that screening mammography only "marginally" reduced the rate at which women are first seen with late-stage breast cancer.

In fact, women under 40 who did not get screened had a slightly lower mortality rate overall than those who did.

They said that falling breast cancer mortality rates were more likely linked to better treatment, not to screening.

According to cancer researcher and clinician Susan Love, cancer prevention and treatment were more fruitful areas for investment than screening.

She said mammography misses around one in five tumours.

And biostatistician Donald Berry, of the M.D. Anderson Cancer Center in Houston, said that most breast cancers are not lethal, however they are found.

He said that screening mammograms tended to pick up the more slow-growing tumours, which were usually not a threat to a woman's life.

People might have such tumours removed, and then believe that screening had saved their lives.

Clinicians will now focus on biological markers that distinguish between the lethal and benign types of breast cancer.



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