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

UN: 1 Million Somalis at Risk of Hunger

Group warns region is in dire need of humanitarian aid, with at least 200,000 children under age of five acutely malnourished as drought hits southern, central part of nation More

Human Rights Groups Allege Supression of Freedoms in Thailand

Thailand’s military, police have suppressed release of independent report assessing human rights in kingdom during first 100 days of latest coup More

Jennifer Lawrence Contacts FBI After Nude Photos Hacked

'Silver Linings Playbook' actress' photos were posted on image-sharing forum 4chan; Federal Bureau of Investigations is looking into matter 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.
Ukraine Schools Resume Classes, Donate to Government Forcesi
X
September 02, 2014 12:58 PM
A new school year has started in Ukraine but thousands of children in the war-torn east are unable to attend because of ongoing clashes with pro-Russia rebels. In Ukraine's capital, patriotic education has become the norm along with donations to support injured security forces fighting to take back rebel-held areas. VOA's Daniel Schearf reports from Kyiv.
Video

Video Ukraine Schools Resume Classes, Donate to Government Forces

A new school year has started in Ukraine but thousands of children in the war-torn east are unable to attend because of ongoing clashes with pro-Russia rebels. In Ukraine's capital, patriotic education has become the norm along with donations to support injured security forces fighting to take back rebel-held areas. VOA's Daniel Schearf reports from Kyiv.
Video

Video US Detainees Want Negotiators for Freedom in North Korea

The three U.S. detainees held in North Korea were permitted to speak with foreign media Monday. The government of Kim Jong Un restricted the topics of the questions, and the interviews in Pyongyang were limited to five minutes. Each of the men asked Washington to send a representative to Pyongyang to secure his release. VOA’s Carolyn Presutti has our story.
Video

Video Internet, Technology Offer New Tools for Journalists

The Internet and rapidly evolving technology is quickly changing how people receive news and how journalists deliver it. There are now more ways to tell a story than ever before. One school in Los Angeles is teaching the next generation of journalists with the help of a state-of-the-art newsroom. Elizabeth Lee has this report.
Video

Video Turkmen From Amerli Describe Survival of IS Siege

Over the past few weeks, hundreds of Shi'ite Turkmen have fled the town of Amerli seeking refuge in the northern city of Kirkuk. Despite recent military gains after U.S. airstrikes that were coordinated with Iraqi and Kurdish forces, the situation remains dire for Amerli’s residents. Sebastian Meyer went to Kirkuk for VOA to speak to those who managed to escape.
Video

Video West Africa Ebola Vaccine Trials Possible by Early 2015

A U.S. health agency is speeding up clinical trials of a possible vaccine against the deadly Ebola virus that so far has killed more than 1,500 people in West Africa. If successful, the next step would be a larger trial in countries where the outbreak is occurring. VOA's Carol Pearson has more.
Video

Video Survivors Commemorate 70th Anniversary of Nazi Liquidation of Jewish Ghetto

When the German Nazi army occupied the Polish city of Lodz in 1939, it marked the beginning of a long nightmare for the Jewish community that once made up one third of the population. Roughly 200,000 people were forced into the Lodz Ghetto. Less than 7,000 survived. As VOA’s Kane Farabaugh reports, some survivors gathered at the Union League Club in Chicago on the 70th anniversary of the liquidation of the Lodz Ghetto to remember those who suffered at the hands of the Nazi regime.
Video

Video Cost to Raise Child in US Continues to Rise

The cost of raising a child in the United States continues to rise. In its latest annual report, the U.S. Department of Agriculture says middle income families with a child born in 2013 can expect to spend more than $240,000 before that child turns 18. And sending that child to college more than doubles that amount. VOA’s Deborah Block visited with a couple with one child in Alexandria, Virginia, to learn if the report reflects their lifestyle.
Video

Video Chaotic Afghan Vote Recount Threatens Nation’s Future

Afghanistan’s troubled presidential election continues to be rocked by turmoil as an audit of the ballots drags on. The U.N. says the recount will not be completed before September 10. Observers say repeated disputes and delays are threatening the orderly transfer of power and could have dangerous consequences. VOA correspondent Meredith Buel reports.

AppleAndroid