News today about a Canadian study on mammography has renewed the debate over the test’s effectiveness and prompted plenty of questions to us at the American Cancer Society. The new report, appearing on bmj.com is actually updated data from a study that’s been ongoing for many years. It finds that screening does not reduce deaths from breast cancer, but can lead to many cancers being found that would have caused no problems during the patients’ lifetime.
We asked Richard C. Wender, M.D., American Cancer Society chief of cancer control, for some thoughts about the new work.
“First and foremost, this study by itself is not enough to cause a change in our recommendations for annual screening using mammography for women starting at age 40.
“The Canadian study has been included in the American Cancer Society’s guideline reviews for many years. This long-term data will be included again as our Guidelines Committee reviews the evidence for their next update, expected later this year.
“Although this 25 year update didn’t add much new information, the overall findings are important. But they are at odds with several other trials on mammography. Even the U.S. Preventive Services Task Force, a group that has been somewhat skeptical of mammography, agrees that screening reduces the relative risk of breast cancer death by about 15 percent in women ages 40 to 59.
“Finally, death rates from breast cancer have dropped more than 30 percent from their peak thanks to a combination of better treatments, heightened awareness, and early detection. The fact is mammography is not as effective as some people say, and not as ineffective as others say. Women need the truth about its benefits and its limitations. Exaggerating either one helps no one.
“We continue to believe women should get an annual mammogram starting at age 40, and that it is very important that they receive quality care, a part of the discussion that has been largely lost in the debate.”