In the last couple of years, there has been a tsunami of news reports – many of them conflicting – about the latest and best research on the effectiveness of breast cancer screening.
For years, women in their 40s were told to get annual mammography exams. Then a federal panel recommended postponing annual screening until 50 for most women. Various breast cancer advocacy organizations and medical groups took differing positions on the issue.
And just to add to the confusion, we had the advice of celebrity patients like Andrea Mitchell and Giuliana Rancic, breast cancer survivors who told their fans that "early detection saves lives."
In the latest wrinkle, a study published in the prestigious New England Journal of Medicine questions whether the increase in breast cancer survival rates in the last three decades is due to increased use of mammography. Instead, the authors of the study argue that better treatments are the reason why far fewer women are dying of breast cancer.
In fact, they argue that mammography may be violating the fundamental principal of medicine: first, do no harm. They say that the widespread use of mammograms results in the overdiagnosis of breast cancer in about 70,000 patients a year.
Overdiagnosis refers to early screening that detects cancer or precancerous tissue that might never progress to life-threatening illness. Nonetheless, 1.3 million American women have suffered the consequences of overdiagnosis in the last 30 years. That means that they may have had surgery or have taken medication that did not increase their lifespan.
So once again, women are left bewildered. I am scheduled for my annual mammogram in January and I will get it. But I think that this is a good time for women to talk to their doctors about how all this new information affects them. The ultimate choice is between you and your doctor.
