Published November 29, 2012
Are women possibly receiving too many checkups for breast cancer? One group thinks so.
Reuters is reporting researchers published a new analysis in the New England Journal of Medicine (NEJM), stating revised guidelines issued by the U.S. Preventive Services Task Force in 2009 can result in potential over-analysis, outraging other medical experts.
The study explored three decades of U.S. government data and the results revealed nearly one in three patients (1.3 million women), whose cancer was detected through routine mammograms were treated for tumors that may not have been life threatening. However, while routine screening has been recommended by the American Cancer Society for women over age 40 the new task force recommends mammography every two years for women ages 50 to 74 years old. Current guidelines say screening should take place every two years for women over 50, but the new study warns early detection can lead to over-analyzing.
“Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer,” explains the report. “Although it is not certain which women have been affected, the imbalance suggests that there is substantial overdiagnosis, accounting for nearly a third of all newly diagnosed breast cancers, and that screening is having, at best, only a small effect on the rate of death from breast cancer.”
Dr. Elizabeth Arleo of Weill Medical College of Cornell University examined the impact of the revised task force guidelines on women 40 to 49 years of age and 65 years and older. She studied data on screening mammography between 2007 and 2010. Out of those years, 43,351 mammograms were performed, detecting 205 breast cancers. Nearly 20 percent of cancers detected were found in women in their 40s.
“In our book, it seems unacceptable to miss 19 percent of breast cancers, half of which were invasive,” said Arleo to Reuters. She dismissed the NEJM analysis, calling it flawed mainly because no one can say for sure which cancers would progress to a life-threatening state.
Not only does the American Cancer Society also recommend screening mammograms for women beginning at age 40, but they also had issues with the new study by NEJM.
“The study states that mammography has led to overdiagnosis and thus overtreatment of breast cancer, with nearly one in three newly diagnosed breast cancers being detected and treated even though they would never have caused a problem,” says Dr. Len Lichtenfeld, Deputy Chief Medical Officer of the American Cancer Society, to Fox News Latino. “The authors’ conclusion--that, despite substantial increases in the number of cases of breast cancers caught early, mammography has only marginally reduced the rate at which women present with advanced cancer--must be viewed with caution.”
Lichtenfeld further elaborates reductions in deaths from are due to several factors, including the rise of mammographic screening and increased awareness. In 2011, there were over 39,000 mammograms conducted, a spike in comparison to 2007 when over 35,000 women were screened. Despite routine checkups, women, particularly Latinas, are still suffering from breast cancer. Hispanic death rates are consistently third behind blacks and whites.
Lichtenfeld believes more studies are required to solve this ongoing debate concerning women and mammograms.
“The Society recognizes that overdiagnosis is a matter deserving of attention,” he says. “There is little question that over time we will continue to refine and improve our ability to determine which women are more or less likely to benefit from different approaches to screening and treatment.”