“MAMMOGRAMS SAVE LIVES” is often a rallying cry for many breast cancer (BC) organizations, facebook pages, health e-cards, and posters. And to some degree, testing for BC makes sense. Diagnosing cancer earlier in the course of the disease means better outcomes.
What you will read below is that
Further, “for each BC death prevented, about three over-diagnosed cases will be identified and treated.”
Therefore, you have got to ask yourself if increased mammogram testing is worth it. If a woman is diagnosed with BC through a mammogram, lives with BC than she would have otherwise, but eventually dies from BC, is she better off? Would this ficticious women have died from BC at the same age, mammogram or no? Did the earlier diagnosis extend her life by 2,4,6 years? Even though she lived with the fear and anxiety of breast cancer for these 2,4,6 extra years?
In order to understand the article linked below, you must start with the basic metrics for cancer, 1) incidence, 2) survival, and 3) mortality-
“Cancer survival rates vary by the type of cancer, stage at diagnosis, treatment given and many other factors, including country. In general survival rates are improving, although more so for some cancers than others.”
Are you a breast cancer survivor? How many mammograms have you had in your lifetime? What do you think about mammograms?
“OBJECTIVE: To determine the relationship over time between 5-year cancer survival and 2 other measures of cancer burden, mortality and incidence…
RESULTS: From 1950 to 1995, there was an increase in 5-year survival for each of the 20 tumor types. The absolute increase in 5-year survival ranged from 3% (pancreatic cancer) to 50% (prostate cancer). During the same period, mortality rates declined for 12 types of cancer and increased for the remaining 8 types. There was little correlation between the change in 5-year survival for a specific tumor and the change in tumor-related mortality…
CONCLUSION: Although 5-year survival is a valid measure for comparing cancer therapies in a randomized trial, our analysis shows that changes in 5-year survival over time bear little relationship to changes in cancer mortality. Instead, they appear primarily related to changing patterns of diagnosis. JAMA. 2000.”
“New research analysing breast cancer mortality data spanning almost 40 years concludes that breast cancer screening does not yet show an effect on mortality statistics…The review also found that for each breast cancer death prevented, about three over-diagnosed cases will be identified and treated…Lead researcher, Ms Toqir Mukhtar, says that while the new results do not rule out a benefit of breast cancer screening at the level of individual women, “the effects are not large enough to be detected at the population level.”…
“Measuring the effectiveness of mammography screening is a fundamental area of concern in countries which have established mammography screening programmes. Clinical trials have indicated that several years have to elapse between the start of screening and the emergence of a reduction in mortality. Yet our data shows that there is no evidence of an effect of mammographic screening on breast cancer mortality at the population level over an observation period of almost 40 years.”
“Long term follow-up does not support screening women under 60…”
If we assume that screening reduces breast cancer mortality by 15% and that overdiagnosis and overtreatment is at 30%, it means that for every 2000 women invited for screening throughout 10 years, one will avoid dying of breast cancer and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress including anxiety and uncertainty for years because of false positive findings…”
“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…”
“How will we ever hope to make desperately needed progress in the breast cancer crisis when the mainstream breast cancer movement continues to push an outdated and scientifically debunked agenda? The evidence has been mounting that the time has come to radically re-think the tenets of the breast cancer awareness movement, because it is clear that the fundamental philosophy behind “early detection” is flawed…”
“On the contrary, mammography appeared to be preventing only one death for every 1,000 women screened, while causing harm to many more. Their thorough review left them no choice but to recommend that no new systematic mammography screening programs be introduced, and that a time limit should be placed on existing programs…”3 Primary Reasons the Swiss Medical Board Recommended No More Systematic Mammograms…