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

How to Safeguard Your Mobile Privacy

As the digital world becomes more mobile, so too do concerns about eroding privacy and increased hacking More

'Desert Dancer' Chronicles Iranian Underground Dance Troupe

Film by Richard Raymond is based on true story of Afshin Ghaffarian and his friends More

Obesity Poses Complex Problem

Professor warns of obesity’s worldwide health impact 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.
Rolling Thunder Run Reveals Changed Attitudes Towards Vietnam Wari
X
Katherine Gypson
May 25, 2015 1:32 AM
For many US war veterans, the Memorial Day holiday is an opportunity to look back at a divisive conflict in the nation’s history and to remember those who did not make it home.
Video

Video Rolling Thunder Run Reveals Changed Attitudes Towards Vietnam War

For many US war veterans, the Memorial Day holiday is an opportunity to look back at a divisive conflict in the nation’s history and to remember those who did not make it home.
Video

Video Female American Soldiers: Healing Through Filmmaking

According to the United States Defense Department, there are more than 200-thousand women serving in the U.S. Armed Forces.  Like their male counterparts, females have experiences that can be very traumatic.  VOA's Bernard Shusman tells us about a program that is helping some American women in the military heal through filmmaking.
Video

Video Iowa Family's Sacrifice Shaped US Military Service for Generations

Few places in America have experienced war like Waterloo. This small town in the Midwest state of Iowa became famous during World War II not for what it accomplished, but what it lost. As VOA’s Kane Farabaugh reports, the legacy of one family’s sacrifice is still a reminder today of the real cost of war for all families on the homefront.
Video

Video On Film: How Dance Defies Iran's Political Oppression

'Desert Dancer' by filmmaker Richard Raymond is based on the true story of a group of young Iranians, who form an underground dance troupe in the Islamic Republic of Iran. This is the latest in a genre of films that focus on dance as a form of freedom of expression against political oppression and social injustice. VOA’s Penelope Poulou has more.
Video

Video Turkey's Ruling Party Trying to Lure Voters in Opposition Stronghold

Turkey’s AK (Justice and Development) Party is seeking a fourth successive general election victory, with the goal of securing two-thirds of the seats in Parliament to rewrite the constitution and change the country's parliamentary system into a presidential one. To achieve that, the party will need to win seats in opposition strongholds like the western city of Izmir. Dorian Jones reports.
Video

Video Millions Flock to Ethiopia Polls

Millions of Ethiopians cast their votes Sunday in the first national election since the 2012 death of longtime leader Meles Zenawi. Mr. Meles' party, the Ethiopian People's Revolutionary Democratic Front, is almost certain of victory again. VOA's Anita Powell reports from Addis Ababa.
Video

Video Scientists Testing Space Propulsion by Light

Can the sun - the heart of our solar system - power a spacecraft to the edge of our solar system? The answer may come from a just-launched small satellite designed to test the efficiency of solar sail propulsion. Once deployed, its large sail will catch the so-called solar wind and slowly reach what scientists hope to be substantial speed. VOA’s George Putic reports.
Video

Video FIFA Trains Somali Referees

As stability returns to the once lawless nation of Somalia, the world football governing body, FIFA, is helping to rebuild the country’s sport sector by training referees as well as its young footballers. Abdulaziz Billow has more from Mogadishu.
Video

Video With US Child Obesity Rates on the Rise, Program Promotes Health Eating

In its fifth year, FoodCorps puts more than 180 young Americans into 500 schools across the United States, where they focus on teaching students about nutrition, engaging them with hands-on activities, and improving their access to healthy foods whether in the cafeteria or the greater community. Aru Pande has more.
Video

Video Virginia Neighborhood Draws People to Nostalgic Main Street

In the U.S., people used to grow up in small towns with a main street lined by family-owned shops and restaurants. Today, however, many main streets are worn down and empty because shoppers have been lured away by shopping malls. But in the Del Ray neighborhood of Alexandria, Virginia, main street is thriving. VOA’s Deborah Block reports it has a nostalgic feel with its small restaurants and unique stores.

VOA Blogs