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

African States Push to Keep Boko Haram Offline

Central African telecoms ministers working with Nigeria to block all videos posted by Boko Haram in effort to blunt Nigerian militant group's propaganda More

Falling Oil Prices, Internet-Savvy Youth Pose Challenge for Gulf Monarchies

Across the Gulf, younger generations are putting a strain on traditional politics More

Philippines Call Center Workers Face Challenges

Country has world’s largest business process outsourcing, or BPO, industry, employing some one-million workers More

This forum has been closed.
Comment Sorting
Comments
     
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: http://www.supplements-and-health.com/mammograms.html ).

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.
US Supreme Court Hears Hijab Discrimination Casei
X
Katherine Gypson
February 25, 2015 11:30 PM
The U.S. Supreme Court has heard opening arguments in a workplace religious discrimination case that examines whether a clothing store can refuse to hire a young woman for wearing the headscarf she says is a symbol of her Muslim faith. Katherine Gypson reports from the Supreme Court.
Video

Video US Supreme Court Hears Hijab Discrimination Case

The U.S. Supreme Court has heard opening arguments in a workplace religious discrimination case that examines whether a clothing store can refuse to hire a young woman for wearing the headscarf she says is a symbol of her Muslim faith. Katherine Gypson reports from the Supreme Court.
Video

Video Falling Gas Prices Hurt Nascent Illinois Hydraulic Fracturing Industry

Falling oil prices are helping consumers purchase cheaper petroleum at the pump. But that’s made hydraulic fracturing or “fracking” less economically viable for the companies in the United States invested in the process. VOA’s Kane Farabaugh reports on one Midwestern town that was hoping to change its fortunes by cashing in on the next big U.S. oil boom.
Video

Video Fighting in Sudan's South Kordofan Fuels Mass Displacement

Heavy fighting in Sudan's South Kordofan state is causing hundreds of thousands to flee into uncertain conditions. Local aid organizations estimate as many as 400,000 civilians have been internally displaced since the conflict began more than three years ago, while another 250,000 have fled across the border to refugee camps in South Sudan. VOA's Adam Bailes reports.
Video

Video Lao Dam Project Runs Into Opposition

A Lao dam project on a section of the Mekong River is drawing opposition from local fishermen, international environmental groups and neighboring countries. VOA's Say Mony visited the region to investigate the concerns. Colin Lovett narrates.
Video

Video A Filmmaker Discovers Her Biracial Identity in "Little White Lie

Lacey Schwartz grew up in an upper middle-class Jewish family, in a town in upstate New York where almost everyone she knew was white. She assumed that she was, as well. Her recent documentary, Little White Lie, tells the story of how she uncovered the secret of her true racial background. VOA’s Carolyn Weaver has more on the film.
Video

Video Deep Under Antarctic Ice Sheet, Life!

With the end of summer in the Southern hemisphere, the Antarctic research season is over. Scientists from Northern Illinois University are back in their laboratory after a 3-month expedition on the Ross Ice Shelf, the world’s largest floating ice sheet. As VOA’s Rosanne Skirble reports, they hope to find clues to explain the dynamics of the rapidly melting ice and its impact on sea level rise.
Video

Video US-Cuba Normalization Talks Resume Friday

Negotiations aimed at normalizing diplomatic relations between the U.S. and Cuba resume Friday. On the table: lifting a half-century trade embargo and easing banking and travel restrictions. There's opposition in Congress, but some analysts say there may be sufficient political and economic incentives in both nations for a potential breakthrough this year. VOA's Mil Arcega reports.
Video

Video Pakistan's Deadline For SIM Registration Has Cellphone Users Scrambling

Pakistani cell phone users have until midnight Thursday to register their SIM cards, or their service will be cut off. While some privacy experts worry about government intrusion, many Pakistanis are just worried about keeping their phone lines open. VOA Deewa reporter Arshad Muhmand has more from Peshawar.
Video

Video Myanmar Warns Factory Workers to End Strikes

Outside Myanmar's main city Yangon, thousands of workers walked off their jobs earlier this month demanding a doubling of their wages, pay raises after a year and input from labor unions on industrial regulations. Since Friday, the standoff has grown more tense as police moved in to disrupt the sit-ins, resulting in clashes that injured people from both sides. VOA correspondent Steve Herman visited industrial zones which have become a focus of Myanmar's fledgling workers rights movement.
Video

Video Oscar Winners Do More Than Thank the Academy

The Academy Awards presentation is Hollywood’s night to reward the best movies from the previous year. It’s typically a lot of glitter, a lot of thank you’s, a lot of speeches. But many of this year’s speeches carried messages beyond the thank you's. VOA’s Carolyn Presutti takes a look.

All About America

Circumventing Censorship

An Internet Primer for Healthy Web Habits

As surveillance and censoring technologies advance, so, too, do new tools for your computer or mobile device that help protect your privacy and break through Internet censorship.
More