I’m sure this is going to be controversial.  I’ve already read on the Internet where some people think this has to do with cutting costs, but I’m not so sure that is the case.  Studies from Denmark, Sweden, Canada, India and Scotland, all deal with the effectiveness and advisability of yearly mammogram screening.

I’m sure there are many anecdotes from women who believe mammograms saved their lives and I’m sure that’s true.  But there are other stories of women who have undergone unnecessary biopsies and repeated mammograms due to false positives.  My own mother had a mastectomy because of a breast cancer a mammogram found, but was told a couple of years later that it was a type of cancer they no longer remove as it does not spread and is contained within a milk duct.

I personally have never thought compressing a breast and irradiating it was a good idea and asked a doctor to write an order for a ultrasound instead, which he refused to do even thought I would have paid for it myself.  Come to find out he had an interest in the company that did the mammograms for the patients he referred.

The best we can each do, is look at the information, discuss it with a trusted doctor and make our decisions based on that information.

Federal task force makes radical change in breast cancer screening guidelines

Women in their 40s should stop routinely getting annual mammograms, and older women should cut back to one scheduled exam every other year, an influential federal task force has concluded, challenging the use of one of the most common medical tests.

In its first reevaluation of breast cancer screening since 2002, the federal panel that sets government policy on prevention recommended the radical change, citing evidence that the potential harms of all women getting annual exams beginning at age 40 outweigh the benefits.

“We’re not saying women shouldn’t get screened.   Screening does save lives,” said Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations Monday in a paper being published in Tuesday's Annals of Internal Medicine. “But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully.”

[snip]

Several patient advocacy groups and many breast cancer experts praised the shift, saying it represented a growing recognition that more tests, exams and treatments are not always beneficial and, in fact, can harm patients. Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies, and unneeded treatment, including surgery, radiation and chemotherapy.

REST OF ARTICLE

Does mammography screening really save lives?

COPENHAGEN, DENMARK. Medical researchers at the Nordic Cochrane Centre have reached the surprising conclusion that “screening for breast cancer with mammography is unjustified”. The researchers reviewed eight randomized trials aimed at determining the effect of mammography screening on mortality from breast cancer. The trials carried out in the United States, Canada, Scotland, and Sweden involved over 500,000 women. A careful study of the design of the trials showed that six of them were biased in a direction which would tend to exaggerate the benefits of mammography. In some of the trials the women in the screening group were significantly younger than those in the control group. In others the screened women were in a significantly higher socio- economic stratum than the women in the control group. The researchers conclude that only two studies, the Canadian Mammography Screening Study and a study carried out in Malmo, Sweden were sufficiently unbiased to be of value. The pooled results of these studies showed no reduction in breast cancer mortality due to the use of mammography screening. The researchers back up their contention that mammography screening is unjustified by pointing out that there has been no decrease in breast cancer mortality in Sweden since the introduction of mammography in 1985.

Mammography: A risky procedure?

ABERDEEN, SCOTLAND. Researchers at the University of Aberdeen warn that the compressive force used in order to obtain useable mammograms may be a contributing factor to breast cancer. The British standard for the force used to squeeze the breast as flat as possible corresponds to placing twenty 1 kilogram bags of sugar on each breast. The researchers fear that this force may be excessive and enough to dislocate and spread any existing cancer cells. Animal experiments have shown that the number of cancer sites can increase by as much as 80% when tumors are manipulated mechanically. A recent study in Malmo, Sweden found that the death rate from breast cancer among women under 55 was 29% higher in a group which had been screened with mammography than in the unscreened control group. The screening procedure used “as much compression force as the women could tolerate”.
The Lancet, July 11, 1992, p. 122

Canadian study questions the benefits of mammography

TORONTO, ONTARIO. The results of the Canadian National Breast Screening Study are now in. This massive study involving almost 90,000 Canadian women aged 40 to 59 was carried out between 1980 and 1985 and provided for a seven-year follow-up period. The researchers conclude that although annual mammograms were found to be effective in detecting small, node-negative tumors at an early stage there was no indication that regular mammography had any impact on the rate of death from breast cancer within the 7 year follow-up period. NOTE: This study has created a great deal of controversy and has been vehemently condemned by many U.S. radiologists.
Canadian Medical Association Journal, November 15, 1992, pp. 1459-88

Vested interests attack Canadian mammography study

BOSTON, MASSACHUSETTS. The major, surprising finding of the Canadian National Breast Screening Study was that there is no evidence that screening for breast cancer with mammography is effective for women under 50 years of age. Not surprisingly, this conclusion has been vehemently attacked by American radiologists. Women in their 40s are the best customers for regular mammograms. As many as 40% of them have an annual mammogram at a cost of $50- 100 each. Now another study in Sweden supports the Canadian findings. Dr. Lazlo Tabar followed 35,000 women aged 40-49 for 11 years. He found no evidence that regular mammographic screening of these women had any benefits.
Gray, Charlotte. US resistance to Canadian mammogram study not only about data. Canadian Medical Association Journal, Vol. 148, No. 4, February 15, 1993, pp. 622-23

Is mammography necessary at all?

BOMBAY, INDIA. Dr. Mittra of Tata Memorial Hospital in Bombay adds his voice to the growing chorus of doctors and scientists questioning the value of routine mammography screening. He believes that physical examination by skilled practitioners is just as effective as mammography in detecting life- threatening tumors. He also points out that the National Breast Screening Study in Canada found no difference in mortality between women screened by physical examination alone and women screened with physical examination plus mammography. He estimates that the cost of mammography is 5-10 times higher than the cost of physical examination. Dr. Mittra points out that mammography may cause anxiety in women awaiting their test results and often leads to unnecessary biopsies and treatments. He concludes that the question is not “how to refine mammographic screening, but whether we need it at all”.
Mittra, I. Breast screening: the case for physical examination without mammography. The Lancet, Vol. 343, February 5, 1994, pp. 342-44

Breast cancer screening may cause more harm than good

VANCOUVER, CANADA. Women over 40 years of age have long been advised to have an annual mammogram. Now questions are being raised within the medical community about the wisdom of this advice. Two Canadian medical professors conclude that the benefits of a general program of breast cancer screening are marginal, that the potential for harm is substantial, and that the cost is enormous. They estimate that only one in every 20,000 women screened actually receive a benefit from the procedure; this converts into a cost of about $1.2 million for each life saved. The professors do not question the value of mammography in the case of women who have signs of the disease, but consider mass screening to be a waste of resources.
An Australian team from the University of Queensland echoes the conclusions of the Canadians. They see little, if any, benefit in screening women under 50 years of age, but they do point out some of the serious negative effects – later ill effects from the radiation they are exposed to during the mammogram, the possibility that an existing tumor may spread due to the pressure exerted on the breast during screening, and the anxiety caused by frequent false- positive results. The Canadian researchers point out that a false-positive result may not only produce great stress, but may also lead to unnecessary biopsies and surgery. They also point out that mammography misses 10-15 per cent of early breast cancers thus providing a false sense of security. Both teams agree that mass screening of women under 50 years is of little benefit and has the potential to cause a great deal of harm.
Glasziou, Paul P., et al. Mammographic screening trials for women aged under 50. The Medical Journal of Australia, Vol. 162, June 19, 1995, pp. 625-29
Wright, Charles J. and Mueller, C. Barber. Screening mammography and public health policy: the need for perspective. The Lancet, Vol. 346, July 1, 1995, pp. 29-32

SOURCE of the above studies.