Do We Need So Many Mammograms?

From the NEJM:

We estimated that in 2008, breast cancer was over-diagnosed in more than 70,000 women; this accounted for 31% of all breast cancers diagnosed.

Data for U.S. women 40+:

Their conclusion:

Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer. Although it is not certain which women have been affected, the imbalance suggests that there is substantial over-diagnosis, accounting for nearly a third of all newly diagnosed breast cancers, and that screening is having, at best, only a small effect on the rate of death from breast cancer.

HT: Kevin Outterson.

Comments (8)

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  1. Cindy says:

    I wonder how many of these cases are false-positives. It’s agonizing to think you have cancer and the abnormal result turn out to be nothing and it may even contribute to a loss of faith in screening for women who need it.

    Preventive care needs to be balanced against the appropriate risk factors for an individual. A woman in her early 30′s with no family history of cancer and no risk factors has no business getting a mammogram.

  2. Devon Herrick says:

    My mother always claimed mammograms were bogus – as were most breast cancer treatments. She survived a breast cancer diagnosis by about eight years, and died of something unrelated. After her diagnosis, she never had surgery and was treated using an alternative cancer therapy.

  3. Louise says:

    In college, I worked in a genetic testing clinic. As I understood it (as a student researcher, NOT a professional) was that early detection is actually only marginally helpful in breast cancer cases because women genetically predisposed to the most aggressive forms will likely have worse outcomes regardless of how early their cancer detection takes place.

    That said, many of those women were advised to cut risk via prophylactic surgeries which were not much cheaper.

  4. seyyed says:

    even if there are more mammograms, isn’t it better to be safe than sorry?

  5. Jordan says:

    This is kind of misleading. The study says that they are finding tumors, but many of them would never have produced symptoms. I have to agree with seyyed.

  6. Jim says:

    Louise, I had never thought about that. Either way, I’d much rather have my wife get a mamogram than not, and wish I had.

  7. Julianne says:

    According to what we saw on the previous post, screenings can actually worsen or increase the risk of diagnosis of breast cancer. That said, Seyyed, I’m not sure how much safer than sorry women can actually be with/without these mammograms.

  8. August says:

    “overdiagnosed (i.e., tumors were detected on screening that would never have led to clinical symptoms)”

    I’d like to know if I had a tumor that may turn malignant.

    But I also see that “screening is having, at best, only a small effect on the rate of death from breast cancer.” So, I guess we need better treatment of breast cancer, not just identification.