Mammography Screening Debate Reignites

Cheryl Clark, for HealthLeaders Media , August 29, 2011

Screening mammography should be tossed out as an exercise that does more harm than good because it finds lesions that aren't clinically relevant and leads to radiation-linked deaths. Or, it is an essential part of preventive health, having reduced breast cancer mortality by 30% between 1990 and 2007.

Which is it?

Authors of three papers in the September issue of the journal Radiology are reigniting the conflict with contradictory reports, two of which advocate for  the procedure, and one which suggests the practice may kill more women than it saves through secondary cancers and heart disease.

The controversy was provoked by one of the papers, which describes findings from a Swedish study of 133,065 women between the ages of 40 and 74 in two counties. The women were randomized into two groups, one of which was invited to mammographic screening, while the other, a control, received usual care. Both groups were followed for up to 29 years.

"There were 351 breast cancer deaths among the 77,080 subjects in the active study population group and 367 deaths among the 55,985 subjects in the passive study population group," wrote Stephen Duffy, professor of cancer screening at Queen Mary University of London, the lead author of the Swedish study with colleagues.

At 29 years of follow-up, the researchers determined that the number of women needed to undergo screening for seven years to prevent one breast cancer death was between 414 and 519, depending on the case status and cause of death source used.

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3 comments on "Mammography Screening Debate Reignites"

John D. Keen MD (9/7/2011 at 8:57 AM)
Dr. Destounis: Please read our article more carefully in Radiology. You are misrepresenting our position. Overdiagnosis turns healthy women into cancer patients, because all detected cancers are treated. We are not advocating watchful waiting as you imply-we advocate that women be told the truth about the problem of overdiagnosis. Let us have an honest debate. John D. Keen, MD

mbrandt2977 (8/29/2011 at 2:27 PM)
My mother was recently diagnosed with Breast Cancer through a mamogram that was clear last year. The cancer is the size of a pea and would not have been felt until it is much more advanced. At 45, I will continue to get my annual mammogram!

linda (8/29/2011 at 9:16 AM)
As a 13 year breast cancer survivor I attribute my survival to early detection and mammography. Many of the women in my Breast Cancer Support group would not have survived if mammograms were not available. I believe the benefit far outweighs the risk. Ask any of us who have survived the horrible disease.




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