>To screen or not to screen – that is the Million Dollar question
This is a very sensitive issue.
I personally have two much loved girl friends who have had breast surgery due to cancer. They may not be alive today without surgical intervention.
Recently there has been much questioning as to the worth, of regular screening mammograms. Do they actually detect tumours? How much radiation is emitted? Why are there so many ‘false positives’? (if there are false positives – are there also false negatives?) Even the monetary value is now being questioned.
Whatever your particular stance on this, the fact remains that according to the prestigious Cochrane Collaboration, which carried out one of the most extensive and unbiased reviews of the literature to date, mammograms not only don’t work as a screening tool, but also increase your risk of cancer and unnecessary treatment.
That is quite a startling revelation isn’t it. After all (at least here in Australia) women are continually bombarded with advertisements, and literature compelling them to have regular mammograms, to ensure any cancer is picked up early, and treated quickly.
Screening for breast cancer with mammography
(this is a plain language summary)Screening with mammography uses X-ray to try to find breast cancer before a lump can be felt. The goal is to treat cancer early, when a cure is more likely.
The review includes seven trials that involved 600,000 women who were randomly assigned to receive screening mammograms or not. The review found that screening for breast cancer likely reduces breast cancer mortality, but the magnitude of the effect is uncertain. Screening will also result in some women getting a cancer diagnosis even though their cancer would not have led to death or sickness. Currently, it is not possible to tell which women these are, and they are therefore likely to have breasts or lumps removed and to receive radiotherapy unnecessarily.
The review estimated that screening leads to a reduction in breast cancer mortality of 15% and to 30% overdiagnosis and overtreatment. This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged. In addition, 10 healthy women, who would not have been diagnosed if there had not been screening, will be diagnosed as breast cancer patients and will be treated unnecessarily.
Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings.
It is thus not clear whether screening does more good than harm. Women invited to screening should be fully informed of both the benefits and harms.
In the latest online edition of WDDTY, Lyn McTaggart has a well written (as always), well researched article exploring this issue.As always when it comes to YOUR HEALTH, read and research as much as you can on a subject, before you jump in at the deep end. Your health care provider will have information, but much of that has been provided by those, who will make the profits from the treatments being recommended. It is always an advantage to get both sides of the story before you make your decision.