Mammography Does Not Reduce Breast Cancer Mortality

Researchers led by Gilbert Welch analyzed data on women over 40 collected between 1975 and 2012. The authors decided to find out if mammography (which has been actively prescribed since the 1980s) helped to detect cancer at an earlier stage.

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It is well known that whoever is forewarned is armed. Regular screening allows you to know in time about the increased risk of developing a particular disease, or to detect the disease in the early stages. However, research shows that some diagnostic methods are not always necessary.

For example, not so long ago, the ineffectiveness of the use of PSA for the early detection of prostate cancer in men was confirmed. An elevated PSA does not always indicate the presence of a tumor, but men, having received test results, are often referred for other examinations that they do not always need - for example, a prostate biopsy. It turned out that the introduction of PSA analysis into the screening program does not at all help to reduce mortality from prostate cancer.

Read more: Tumor markers: execute, cannot be pardoned

Mednovosti spoke with Ilya Fomintsev, executive director of the Cancer Prevention Foundation, about the danger of cancer screening, unnecessary examinations, search for a doctor and much more.

A similar story happens with mammography. Researchers led by Gilbert Welch analyzed data on women over 40 collected between 1975 and 2012. The authors decided to find out if mammography (which has been actively prescribed since the 1980s) helped to detect cancer at an earlier stage.

It turned out that after the introduction of mammographic studies into clinical practice, the number of cases of detecting small tumors (not exceeding 2 cm in diameter) really increased, but metastatic cancer continued to be detected with the same frequency.

Thus, the introduction of mammography did not affect the rate of detection of advanced cancer in any way, but small tumors that could be completely harmless began to be found more often - in 81% of cases it was about "overdiagnosis". This means that women were more likely to be prescribed biopsies and other tests, the risk of complications during which was higher than the possible danger associated with the progression of these small tumors.

Scientists concluded that mammography did increase the detection rate of some forms of cancer, but the introduction of this procedure had virtually no effect on the frequency of detecting fatal forms of breast cancer and, accordingly, did not help prevent their occurrence.

Breast cancer deaths have declined by about 30% since 1990. However, this trend is observed both among women over 40 who are recommended to mammography, and among younger patients who are usually not prescribed this procedure. A more significant contribution to reducing mortality, the authors explain, is made by improving the methods of treating breast cancer.

Source: Even More Evidence That Mammograms Have Been Oversold

A study published online today by the The New England Journal of Medicine added to a growing body of evidence that for every woman who has been helped by a mammogram screening for breast cancer, many more have been harmed.

FiveThirtyEight