Wednesday, April 8, 2009

Do Screening Mammograms Save Lives?

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

There is a recently published article in the open access journal journal BMC Medical Informatics and Decision Making that questions whether “mammograms save lives.”  The analysis of data from the the Surveillance, Epidemiology and End Results Program  was done by two British doctors, John Keen and James Keen. 
The study was done to analyze the claim "mammography saves lives."   The researchers calculated the absolute benefit by first estimating the screen-free absolute death risk from breast cancer.  They used data from .  They then calculated the absolute risk reduction (reduction in absolute death risk), the number needed to screen assuming repeated screening, and the survival percentages without and with screening.
They feel that only 1.8 lives are saved in women with repeated screening over 15 years,beginning at age 50 yr of age, for every 1000 women screened.  The found the survival percentage to be 99.12% without and 99.29% with screening.   They feel that less than 5% of women with screen-detectable cancers have their lives saved.
This is at odds with the American Cancer Society who feels that screening mammograms save the lives of approximately 15% of women who are diagnosed with breast cancer by finding the cancer early.
Who is right?  That’s up for debate.  For now it is still a good recommendation for women to talk to their doctors and weigh their own risk factors.  For now, I will continue to recommend screening mammograms in women without breast symptoms for all women age 40 and older each year.
The question remains, am I doing this for them or for myself (cover your butt—risk of malpractice suite if delayed diagnosis of breast cancer).  I hope I’m doing it for them, but there is some of the later.

"What is the point: will screening mammography save my life?."; BMC Medical Informatics and Decision Making 2009, 9:18 (doi:10.1186/1472-6947-9-18); John D Keen and James E Keen
American Cancer Association

Mammograms (October 2008)
Breast Cancer Screen in Childhood Cancer Survivors – An Article Review (February 2009)
Indications for Breast MRI – an Article Review (March 2009)

1 comment:

Jabulani said...

My mother, who lives in South Africa, is appalled that here in the UK we don't do this. She goes every year and argues that us women in the UK go thru' pap smears every 3 years, so why not go get our mammies grammied as well?

I suspect it is largely because of cost; free mammograms only kick in in your 50s. It's been reduced from 60 but when they found women in their 50s dying with breast cancer, they dropped the age. I guess even our beleagured NHS thinks that mammograms save lives!!

I, who will be 40 in a few months time, have never had one. Perhaps it's time I did!