Mammograms:Necessary?

A Danish study published in the British journal The Lancet suggests that mammograms may be unjustified in attempting to screen for breast cancer.

Researchers analyzed eight mammography screening studies, conducted mostly in Europe, and concluded that "there is no reliable evidence that screening decreases breast cancer mortality." The authors of the paper were prompted to look at the issue because of a study released in Sweden showing no decrease in breast cancer mortality since the nationwide screening program was introduced there in 1985.

Immediately following the publication of the study, the American Cancer Society released a statement vehemently disagreeing with the findings. "The American Cancer Society is in complete disagreement with conclusions drawn by the Danish team," said Harmon J. Eyre, chief medical officer for the American Cancer Society. "In the early 1980s, when only 13% of American women were getting mammograms, the average size of breast tumors at diagnosis was 3.2 centimeters. By the late 1990s, 60% of women in the U.S. were having regular mammograms and the average tumor size had dropped to two centimeters. Also, in most cases diagnosed today, the cancer has not spread to the underarm lymph nodes; decades earlier this was not the case."

According to Eyre, evidence in the United States (where routine mammography has been performed for a longer period of time than in Europe) shows vastly improved diagnosis and chance of recovery. Eyre also attributes part of the reason for the fall of U.S. breast cancer mortality rates to mammography.

"Mammography is beneficial," said Robert J. Smith, director of cancer screening for the ACS, "and it is beneficial because it finds breast cancer early, when a woman has more treatment options."

The ACS recommends that women age 20 years and older receive a clinical breast examination every three years and perform monthly self-examinations, and women over 40 should receive an annual mammogram and yearly clinical exams in addition to monthly self-exams. PR