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Do Regular Mammograms Save Lives? Maybe Not.

Patient Information |
February 24, 2014

Do Regular Mammograms Save Lives? Maybe Not.

  1. Diane E. Judge, APN/CNP

Long-term Canadian study is the latest to question the value of screening mammography.

  1. Diane E. Judge, APN/CNP

The good news about breast cancer is that fewer women are dying from it. At first, experts thought this decrease was because regular screening mammograms found cancers at early, more-curable stages. But new studies have raised questions about mammography. Perhaps the lower death rate from breast cancer is due to better treatments for the disease rather than the ability of mammograms to find it early.

A recent Canadian study in women aged 40 to 59 is the latest to question the usefulness of mammograms. Some study participants had annual mammograms and some did not. Over the course of 25 years, about the same number of women in each group developed breast cancer, and about the same number in each group died from these cancers; so for preventing breast cancer deaths, the mammograms did not make a difference.

There are also some downsides to having regular mammograms. They can reveal irregularities that are probably not cancer but aren't exactly normal. In such cases, you may get called back for more testing (another mammogram, ultrasound, biopsy). Even if everything turns out fine, the extra tests cause anxiety, discomfort, and expense. Also — as scary as the words “breast cancer” sound — some cancers found on mammograms would never get worse, spread, or cause death. So women with cancer found with mammography may undergo surgery, chemotherapy, and radiation that can be more harmful than the cancer itself. (It's important to know that here we are talking about “screening” mammograms, done in women with no unusual breast symptoms or findings. If you have a breast lump, a “diagnostic” mammogram is a valuable part of the evaluation.)

Confusing, isn't it? So what should you do? Although many clinicians still recommend annual mammograms starting at age 40, a reasonable approach for now is to follow the U.S. Preventive Services Task Force (USPTSF) guidelines, which are based on the best scientific evidence available in 2009. The Task Force recommends that women at average risk for breast cancer and without changes in their breasts begin mammograms at age 50 and have them every two years. Different guidelines may apply to women who are at higher than average risk for breast cancer because of their personal or family histories.

  • Disclosures for Diane E. Judge, APN/CNP at time of publication Nothing to disclose

Reader Comments (4)

Dr. V Kantariya MD Physician, Family Medicine/General Practice

Breast Cancer can be trickly to diagnose, leading to incorrect treatments. Overdiagnosis and overtreatment in BC are common. What if the Doctor is Wrong? Ask a Second Opinion for Breast Cancer.

CHRIS DAVIS Other, Other

Would you please comment on the new 3D mammography that is now available.

RENATO ROSSI Physician, Family Medicine/General Practice, Italy

Maybe the best thing to do, in my opinion, is to informe womens about benefits and risks of mammography screening and let them the choice.
According with the Gotzsche leaflet (http://www.cochrane.dk/screening/mammography-leaflet.pdf)
we can say that every 2000 womens screened for 10 years:
1 woman will avoid dead for breast cancer
10 womens will be treated for a cancer that never will be clinically evident without screening
about 400-600 womens will have a false positive test

STEVEN HUFF

Thank you for these comments.

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