Britain Takes Another Look at Mammograms and their Benefits
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Advocates and experts urged British health officials to revise informational fliers about mammography in a letter to the Times of London, reported the New York Times on Tuesday. The officials promised to rewrite these fliers to avoid overstating the benefits of mammograms and to include information about the potential harm involved.
In the letter, experts explained that women are not told that up to ten healthy women are given diagnoses (and sometimes surgery) for a slow-growing cancer that was not life threatening, for every one woman actually saved by breast cancer screening. This is a statistic that not many American women are likely to hear either. One survey conducted of American women found that only 7% were even aware that some cancers grow so slowly as to not need treatment.
A 2006 analysis by the Nordic Cochrane Center collaborative, an independent research and information center based in Copenhagen, found that for every 2,000 women age 50 to 70 who are screened for 10 years, one woman will be saved from dying of breast cancer, while 10 will have their lives disrupted unnecessarily by overtreatment. The figures were cited in the letter to The Times.
Director of Cancer Screening Programs in Britain, Julietta Patnick, explained that the informational fliers were being revised but also stated that the figures cited by the Cochrane study were inaccurate. Ms. Patnick said that British studies show that the ratio of women saved to women over treated is more likely one to one.
Often, slow-growing cancers look very similar to aggressive cancers when examined under a microscope so it is not necessarily easy to determine which ones should be left alone.
The United States has more aggressive screening for breast cancer than Britain, where women start at 50 and only get mammograms every 3 years as opposed to the annual mammograms recommended for women starting at age 40 in the U.S.
Dr. Ned Calonge is Chairman of the United States Preventive Services Task Force and explained that in America, mammography is often oversold to women.
“Some women would have the same outcomes, whether the cancer is detected clinically or by mammography,” he said. “And there are women whose cancer is so aggressive we cannot detect it early enough to make a difference in mortality.”
The American Cancer Society still endorses annual mammography and Robert Smith, their director for cancer screening, stated that overdiagnosis is minimal.
In the end, it's obviously the woman's choice and whether you get regular mammograms or regular check-ups or conduct your own self exams, it's always best to stay informed and be aware of changes in your body. Don't hesitate to get a second or third or even a fourth opinion because doctors are human too, and gathering all the information is the only way you will be able to advocate for the best treatment options for yourself. For more information about breast cancer and screening options, click here.