News / Health

Study Could Intensify Mammogram Debate

A nurse is seen assisting a patient undergoing a mammogram.
A nurse is seen assisting a patient undergoing a mammogram.

Related Articles

Protein May Help People with Celiac Disease

Newly identified protein called elafin, tames an enzyme that plays a role in inflammation of small bowel caused by eating certain grains

UN Scientists: Fukushima Meltdown Not Causing Many Cancers

UNSCEAR says it does not expect 'significant changes' in future cancer rates
A new study could intensify the debate about the value of mammograms in screening for breast cancer, particularly for women in their 40s.
The study, researchers at Harvard Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital, revealed that mammograms do save lives, but fewer than previously thought.
It also stated that the risks of regular mammography screening are larger than previously estimated.
Researchers reviewed 50 years of international studies that looked at the risks and benefits of mammography screenings. They concluded that the reduction in mortality from breast cancer was 19 percent due to annual screening for all women.
Women in their 40s, however, saw a 15 percent reduction, while women in their 60s saw a 32 percent drop in mortality, the study reported.
The researchers caution that the benefits of screening depend on an individual’s predisposition to develop the disease, while the risks of screening, namely over diagnosis, are shared among all women.
“While we need more research on mammography’s benefits and harms today, existing data suggest that we have been overestimating the benefits of mammography and underestimating the harms over the years,” said co-author Lydia Pace, research fellow in Women’s Health at Brigham and Women’s in a statement.
“It is really important to have informed discussions with our patients to help them understand the chances that a mammogram will benefit them as well as the possible downsides of getting a mammogram, so that they can incorporate their own values and preferences in making the right decision for themselves,” she said.
According to a 2010 study, most women reported discussing the benefits of cancer screening with their doctors, but few discussed the drawbacks.
Despite a controversial 2009 recommendation by the  U.S. Preventive Services Task Force (USPSTF) that women begin regular screenings at 50, the rate of screening has not dropped.
Dr. Joann Elmore of Harborview Medical Center in Seattle, and Dr. Barnett Kramer of the National Cancer Institute, writing in an editorial accompanying the Harvard study, wrote “For many physicians, conveying nuance and uncertainty may be difficult, especially when patients accept or expect clear answers.”
The Harvard study found that of 10,000 women in their 40s who have annual mammography for 10 years, roughly 190 will be diagnosed with breast cancer.
Of those, five will “avoid death from breast cancer due to screening,” the study said, and 25 of the 190 would die of breast cancer with or without screening.
The rest, the study said, would survive because of better treatment of the disease.
While those benefits are not trivial, but neither are the risks of overdiagnosis, according to the researchers. About 19 percent of women who are diagnosed via mammogram are overdiagnosis, the researchers said. That translates into roughly 36 of the 190 women could receive unnecessary surgery, chemotherapy or radiotherapy.
Still, a 19 percent reduction works out to about 7,600 lives saved. The American Cancer Society (ACS) estimates that about 40,000 U.S. women will die of breast cancer this year.
“I thought [the Harvard study] was a very good effort and approach to organizing older data into a way that clinicians and patients can use to better understand the benefits and drawbacks of mammography screening, particularly for women in their 40s,” said Richard C. Wender, M.D., chief cancer control officer with the ACS.
Wender added that his goal was to highlight areas where there is universal agreement about breast cancer screening.
“There agreement that all women over 50 should undergo screening every one to two years,” he said, adding that there is also agreement that women in their 40s should be screened or they should discuss screening with their clinicians.
“No group says don’t discuss and don’t screen,” he said. “That’s being a little misunderstood.”
The ACS recommends women age 40 and older have annual mammograms, but Wender said updated recommendations are expected later this year.
“What I tell my patients is that the mammogram is not a perfect test,” said Nancy Keating, co-author of the report, associate professor of Health Care Policy at HMS and associate professor of medicine at Brigham and Women’s in a statement. “Some cancers will be missed, some people will die of breast cancer regardless of whether they have a mammogram, and a small number of people that might have died of breast cancer without screening will have their lives saved.”
Despite mammography’s increased scrutiny, Wender points out that of all the years of life lost due to breast cancer, 34 percent of those years occur in women who were diagnosed in their 40s.
The study was published  in the Journal of the American Medical Association.

You May Like

Video In US, Columbus Day Still Generates Controversy

Holiday marks date Columbus discovered Americas, but some are offended by legacy because he enslaved many natives he encountered More

Video Through Sports, Austria Tries to Give Migrants Traction

With 85,000 people expected to claim asylum in Austria this year, its government has made integration through joint physical activities a key objective More

Video Kickboxing Champion Shares Sport With Young Migrants

Pouring into Europe by hundreds of thousands, some migrants, especially youngsters, are finding sports a way to integrate into new host countries More

This forum has been closed.
Comment Sorting
by: Ronald
April 05, 2014 1:05 PM
A large volume of meaningful evidence has been amassed strongly supporting the notion that mammography is mostly ineffective but seriously harmful to most women (laid out in "The Mammogram Myth" by Rolf Hefti: ).

The main problem is that a pro-mammogram perspective has been preferentially disseminated in the commercialized culture, keeping mammogram-dissenting information hidden or obscured to a large degree.

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Amnesty Accuses Saudi Coalition of ‘War Crimes’ in Yemeni
Henry Ridgwell
October 12, 2015 4:03 PM
The human rights group Amnesty International has accused the Saudi-led coalition of war crimes in airstrikes against Houthi rebels in Yemen. Henry Ridgwell reports the group says hundreds of civilians have been killed in strikes on residential areas.

Video Amnesty Accuses Saudi Coalition of ‘War Crimes’ in Yemen

The human rights group Amnesty International has accused the Saudi-led coalition of war crimes in airstrikes against Houthi rebels in Yemen. Henry Ridgwell reports the group says hundreds of civilians have been killed in strikes on residential areas.

Video No Resolution in Sight to US House Speaker Drama

Uncertainty grips the U.S. Congress, where no consensus replacement has emerged to succeed Republican House Speaker John Boehner after his surprise resignation announcement. Half of Congress is effectively leaderless weeks before America risks defaulting on its national debt and enduring another partial government shutdown.

Video New Art Exhibit Focuses on Hope

Out of struggle and despair often comes hope. That idea is behind a new art exhibit at the American Visionary Art Museum in Baltimore, Maryland. "The Big Hope Show" features 25 artists, some of whom overcame trauma and loss. VOA’s Deborah Block reports.

Video Columbus Day Still Generates Controversy as US Holiday

The second Monday of October is Columbus Day in the United States, honoring explorer Christopher Columbus and his discovery of the Americas. The achievement is a source of pride for many, but for some the holiday is marked by controversy. Adrianna Zhang has more.

Video Anger Simmers as Turks Begin to Bury Blast Victims

The Turkish army carried out new air strikes on Kurdistan Workers Party (PKK) targets on Sunday, a day after the banned group announced a unilateral cease fire. The air raids apparently are in retaliation for the Saturday bombing in Turkey's capital Ankara that killed at least 95 people and wounded more than 200 others. But as Zlatica Hoke reports, there are suspicions that Islamic State is involved.

Video Bombings a Sign of Turkey’s Deep Troubles

Turkey has begun a three-day period of mourning following Saturday’s bomb attacks in the capital, Ankara, that killed nearly 100 people. With contentious parliamentary elections three weeks away, the attacks highlight the challenges Turkey is facing as it struggles with ethnic friction, an ongoing migrant crisis, and growing tensions with Russia. VOA Europe correspondent Luis Ramirez reports.

Video Afghanistan’s Progress Aided by US Academic Center

Recent combat in Afghanistan has shifted world attention back to the central Asian nation’s continuing civil war and economic challenges. But, while there are many vexing problems facing Afghanistan’s government and people, a group of academics in Omaha, Nebraska has kept a strong faith in the nation’s future through programs to improve education. VOA’s Greg Flakus has more from Omaha, Nebraska.

Video House Republicans in Chaos as Speaker Favorite Withdraws

The Republican widely expected to become the next speaker of the House of Representatives shocked his colleagues Thursday by announcing he was withdrawing his candidacy. The decision by Majority Leader Kevin McCarthy means the race to succeed retiring Speaker John Boehner is now wide open. VOA National Correspondent Jim Malone reports.

Video German, US Officials Investigate Volkswagen

German officials have taken steps to restore some of the reputation their car industry has lost after a recent Volkswagen diesel emissions scandal. Authorities have searched Volkswagen headquarters and other locations in an effort to identify the culprits in the creation of software that helps cheat on emission tests. Meanwhile, a group of lawmakers in Washington held a hearing to get to the bottom of the cheating strategy that was first discovered in the United States. Zlatica Hoke reports.

Video Why Are Gun Laws So Hard for Congress to Tackle?

Since taking office, President Barack Obama has spoken out or issued statements about 15 mass shootings. The most recent shooting, in which 10 people were killed at a community college, sparked outrage over the nation's gun laws. But changing those laws isn't as easy as many think. VOA's Carolyn Presutti reports.

Video In 'He Named Me Malala,' Guggenheim Finds Normal in Extraordinary

Davis Guggenheim’s documentary "He Named Me Malala" offers a probing look into the life of 18-year-old Malala Yousafsai, the Pakistani teenager who, in 2012, was shot in the head by the Taliban for standing up for her right to education in her hometown in Pakistan's Swat Valley. Guggenheim shows how, since then, Malala has become a symbol not as a victim of brutal violence, but as an advocate for girls’ education throughout the world. VOA’s Penelope Poulou has more.

Video Paintable Solar Cells May Someday Replace Silicon-Based Panels

Solar panels today are still factory-manufactured, with the use of some highly toxic substances such as cadmium chloride. But a researcher at St. Mary’s College, Maryland, says we are close to being able to create solar panels by painting them on a suitable surface, using nontoxic solutions. VOA’s George Putic reports.

VOA Blogs