Written by Dr. Mark
I was going to write about this last week but at the last minute decided not to. So what I hope to touch on here is the obvious topic mentioned in the title and talk about where I’m getting this information from and what we should think of it. Here we go.
First Reference: http://health-and-love-page.com/largest-study-mammograms-pointless/
I stole the title for this daily sprout from the above referenced article. The title, along with the whole article are quite bold in calling mammograms pointless and dangerous.
Recent studies show that this mammography does more harm than any good, as there are things such as false positives, as well as overtreatment and even cancers induced by this radiation (ironic, we know.)
In fact, the largest study ever conducted on this subject, involving over 90.000 women and lasting for ¼ a century, has served to plant some serious doubts concerning mammograms.
The thing is, the percentage of deaths for women who had breast cancer were absolutely identical between those who had mammograms done and those who didn’t.
Additionally, it turns out that a mammogram screening can even be harmful for the patient as sometimes there can be a false result which can lead to unnecessary surgery, chemotherapy, and treatment.
That doesn’t sound so good to me. So a good habit to get into when reading articles like this is that if you don’t know and/or trust the author, in this case its health-and-love-page.com (who I’ve never heard of), it’d be worth the time to check their sources. In the above excerpt they include a link to the study they are referring to, which is usually a good sign but we should check it out.
So the link takes you to a New York Times article from February 2014. “Vast Study Casts Doubts on Value of Mammograms.” Not quite as bold, same idea though. From this article:
One of the largest and most meticulous studies of mammography ever done, involving 90,000 women and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.
It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation.
The study, published Tuesday in The British Medical Journal, is one of the few rigorous evaluations of mammograms conducted in the modern era of more effective breast cancer treatments. It randomly assigned Canadian women to have regular mammograms and breast exams by trained nurses or to have breast exams alone.
Researchers sought to determine whether there was any advantage to finding breast cancers when they were too small to feel. The answer is no, the researchers report.
The study seems likely to lead to an even deeper polarization between those who believe that regular mammography saves lives, including many breast cancer patients and advocates for them, and a growing number of researchers who say the evidence is lacking or, at the very least, murky.
“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.”
The findings will not lead to any immediate change in guidelines for mammography, and many advocates and experts will almost certainly dispute the idea that mammograms are on balance useless, or even harmful.
In my opinion this is a little more informative, but essentially the same information. You probably noticed they referenced a study here and also provided a link, so lets go.
Reference 3: http://www.bmj.com/content/348/bmj.g366
This link brings us to the actual write up of the study being referenced. This is the journal article which is bringing the results of the study to the public. “Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial.” If your not familiar with reading these types of journal articles a good place to start is the abstract, which is usually listed first and broken into sections. If you’re not interested with how they did the study you can scroll down to the results/conclusions and this is where the people actually doing the study, looking at the data, give you their thoughts on what they’ve uncovered.
Their Conclusion (from the Abstract only):
Conclusion Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial.
This is essentially the same information the others were expressing, a bit more detailed, but at the same time, not quite as easy to completely follow. This is why articles like mine you’re reading now and the other 2 I’ve referenced already, to take this information and hopefully make it more readable and understandable and something that can hopefully be helpful with your decisions on the topic presented.
The first article was much bolder than the other 2 I’ve referenced, it did also reference some other sources that I looked over briefly. As bold as they were, they did a good job backing up most of their claims and they offer some good advice to prevent cancer. Maybe their boldness, comes from a feeling of frustration in that this original study was published in 2014 and as far as I’m aware, the AMA still recommends routine mammograms starting at age 40.
We definitely don’t recommend them. If you still want to get tested, I’d recommend thermography instead.
Thanks. – Dr. Mark