Breast Cancer Screening Strategy in JAMA May Be
Deadly for Many Women
Two medical groups continue to recommend annual
mammograms beginning at age 40
April 2, 2014 – Not all physicians are in total
agreement with a report in the Journal of the American Medical
Association (JAMA) that raises new questions about mammograms. At
present, breast cancer screening based primarily on risk - as discussed
article - would miss the overwhelming majority of breast cancers
present in women and result in thousands of unnecessary deaths each
year, according to a statement from two medical groups closely
associated with mammograms.
The American College of Radiology (ACR) and Society
of Breast Imaging (SBI) agree with statements made by Dr. Lydia E. Pace
and Dr. Nancy L. Keating, with Boston’s Brigham and Women’s Hospital, in
their JAMA article that women should discuss mammography with their
doctor and breast cancer diagnosis and treatment may one day be more
The following is the rest of the statement from the
"The United States Preventive Services Task Force (USPSTF)
made similar suggestions to those of this JAMA article. However, an
and Helvie), published in the American Journal of Roentgenology,
using the task force’s own methodology, showed that if USPSTF breast
cancer screening guidelines were followed, approximately 6,500
additional women each year in the U.S. would die from breast cancer.
"It is also likely that thousands more would
endure more extensive and expensive treatments than if their cancers
were found early by a mammogram.
"To arrive at their recommendations, the JAMA
article authors also placed too much emphasis on the obsolete and low
lifesaving benefit of mammography claimed in outdated or discredited
studies. For instance, the Canadian National Breast Screening Study (CNBSS)
has been widely discredited and should not be considered alone or in a
meta-analysis such as this JAMA article. The World Health Organization
long ago excluded the CNBSS from
its analyses of screening mammography’s impact of breast cancer
New Report Latest Casting Doubt on Mammograms:
analysis, which appeared Tuesday in the Journal of the American Medical
Association (JAMA), is the latest to cast doubt on the value of
mammograms, which now account for $8 billion in annual health-care
expenditures in the United States, according to an editorial in the same
A study of 90,000 women released in February found that death rates
from breast cancer and other causes were the same for women who had
mammograms as for those who didn’t.
a panel of the National Cancer Institute argued that the time had
come to alter how cancer is detected, treated and defined because
improved screening has resulted in the overdiagnosis and overtreatment
of cancers that are not life-threatening. Breast cancer was one of the
examples cited in the commentary, which also appeared in JAMA.
“The influential U.S. Preventive Services Task
Force is preparing to update its recommendations on breast cancer
screening, issued in 2009.” Read full news story." -
Washington Post report
a recent interview with CNN, the American Cancer Society echoed
methodological concerns about the study. Breast cancer groups, such as
criticized this study and warned against following the author’s
recommendations. A recent
article published in The Oncologist shows that many other studies
cited in the Pace and Keating article, and elsewhere, regarding
overdiagnosis and potential harms of mammography are not well as
well-founded as has been reported and that their conclusions cannot
simply be taken as fact.
"More recent randomized control trials,
particularly the largest (Hellquist
et al) and longest running (Tabar
et al) breast cancer screening studies in history respectively, have
reconfirmed that regular mammography screening cut breast cancer deaths
by roughly a third (roughly double that claimed in Pace and Keating) in
all women ages 40 and over — including women ages 40–49.
"A study (Otto
et al) published in Cancer Epidemiology, Biomarkers & Prevention
shows mammography screening cuts the risk of dying from breast cancer
nearly in half. A recent
study published in Cancer showed that more than 70 percent of the
women who died from breast cancer in their 40s at major Harvard teaching
hospitals were among the 20 percent of women who were not being
screened. Perhaps most importantly, according to
National Cancer Institute data, since mammography screening became
widespread in the mid-1980s, the U.S. breast cancer death rate,
unchanged for the previous 50 years, has dropped well over 30 percent.
These trial results and government reports may be most applicable to the
current state of breast cancer screening.
"Mammography can detect cancer early when it’s most
treatable and can be treated less invasively — which not only save
lives, but helps preserve quality of life. For more information
regarding the proven effectiveness of regular mammography screening at
reducing breast cancer deaths, please visit
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