Another study questions benefit of mammograms, via Globe, Times

The Globe isn’t sharing much with Boston.com these days. But, you can still access most of the blogs.

Mom, post breast cancer
Mom, post breast cancer

Today’s Daily Dose is on the mammography debate. We all thought early detection was key. For breast cancer, maybe not. 

In a research finding that will add to doubts about the value of breast cancer screening, Canadian researchers determined that women ages 40 to 59 who had yearly mammograms enjoyed no added survival benefit up to 25 years later compared with those who skipped the screening X-rays….

The latest finding, published Tuesday in the British Medical Journal, confirms earlier results from the Canadian trial, which first came out two decades ago and is unlikely to discourage many doctors from recommending screening…

But the researchers also determined that 22 percent of breast cancers initially detected on mammograms in the early 1980s were “over-diagnosed”—meaning they never would have been found otherwise and would not have become life-threatening. Most of these women had surgery to remove these tumors which, in hindsight, was unnecessary…

Such findings haven’t, though, swayed the opinions of most women and doctors, who remain more concerned about a life-threatening cancer going undetected than a harmless one being over-treated

Two local docs defend the procedure:

“Mammography is an imperfect test at best, but at this point, it’s the best test we have,” said Dr. Ann Partridge, a breast oncologist at Dana-Farber Cancer Institute. She and others highlighted some potential methodological flaws of the Canadian study.

For example, Partridge said, technology has improved significantly over the past 30 years with X-ray machines and digitized film that yield clearer images….

Some radiologists have sharply attacked the study investigators, accusing them of having a bias against mammography by designing a study in which the control group of women in their 50s received breast exams performed by skilled nurses every year instead of mammograms.

“The principal investigator set out to prove that all you needed to do was a physical examination,” said Dr. Daniel Kopans, director of breast imaging at Massachusetts General Hospital, in an e-mail responding to the new study finding. “The nurse examiners were highly trained while the radiologists and technologists [who performed the mammograms] had no training.”

Not everyone is sticking with mammography. The advocates at Breast Cancer Action have long questioned its usefulness.

And, the New York Times story offered this telling quote:

“It will make women uncomfortable, and they should be uncomfortable,” said Dr. Russell P. Harris, a screening expert and professor of medicine at the University of North Carolina, Chapel Hill, who was not involved in the study. “The decision to have a mammogram should not be a slam dunk.”

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