Routine breast scans don’t affect mortality – The Globe and Mail

Once again a major study cannot find  benefits in routine mammography for women without symptoms.

Screening programs in which post-menopausal women undergo routine mammography to help detect tumours have virtually no impact on reducing breast-cancer deaths, a new study concludes.

The research, published in today’s edition of the British Medical Journal, says that while breast-cancer mortality has fallen sharply over the years, there is no evidence this is due to systematic screening. Rather, the gains are likely due to better treatment and heightened awareness among women about breast health.

Dr. Karsten Jørgensen, a medical researcher at the Nordic Cochrane Centre in Copenhagen and lead author of the paper, said it is time to fundamentally rethink the current approach rather than continue to engage in wishful thinking.

“We have to start asking unpleasant questions about mammography screening,” he said in an interview.

“Public institutions and large patient advocacy groups have been unwilling to admit that there are serious problems. They have tried to paint a rosy picture against mounting evidence of much smaller benefits than was originally promised and very serious harms,” Dr. Jørgensen said……

Dr. Jørgensen and his team analyzed and compared data from the regions with screening and those without and found:

In the 55-to-74 age group, breast-cancer mortality declined by 1 per cent annually in areas with screening and 2 per cent a year in areas where there was no screening;

In the 35-to-54 age group, where screening is not recommended, breast-cancer mortality fell 5 per cent a year in areas with screening and 6 per cent in those without.

In the 75-and-over age group, there was no change in mortality in any area.

Breast-cancer mortality dropped steadily in the 10 years prior to screening beginning.

 more via Routine breast scans don’t affect mortality – The Globe and Mail.

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  1. Mammography screening generates large numbers of procedures, biopsies and surgeries, with little impact on the numbers of advanced breast cancers. This point was raised by Laura Esserman in her JAMA article. This new study by Karsten Juhl Jørgensen, M.D., of the University of Copenhagen in Denmark is very supportive of Dr Esserman’s conclusions.

    One looming issue is the large numbers of DCIS detected by mammography as small calcifications. Although DCIS is treated aggressively as an invasive cancer, it is really very indolent. DCIS has a 98% -5 year survival with no treatment, and pathologists have been thinking about changing the nomenclature by removing the word “cancer” from its name.

    Here is the NIH consensus statement: “Because of the noninvasive nature of DCIS, coupled with its favorable prognosis, strong consideration should be given to elimination of the use of the anxiety-producing term “carcinoma” from the description of DCIS. ”

    For more: http://www.drdach.com/Mammogram_screening_cancer.html

    jeffrey dach md




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