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Breast cancer: mammography screenings do not save lives
Mammography screenings are less effective than previously thought. Many carcinomas are discovered by the examination, but the screening cannot save lives. It also doesn't prevent cancer. Those responsible for the mammography screening program, on the other hand, draw a positive balance.
Great Expectations in the 1980s According to new studies, the much praised mammography screenings are apparently much less effective than previously thought. In two independent studies, scientists from the University of Toronto and the Swiss Medical Board came to a devastating verdict regarding the benefits of mammography screening. X-ray examination of the breast (mammography) was celebrated as a major step forward in the fight against breast cancer, and as early as the 1980s, based on initial samples, it was expected that breast cancer mortality rates would decrease by 15 to 25 percent using mammography.
Mammography does not reduce mortality Researchers from the University of Toronto (Canada) have accompanied over 90,000 women in a study for 25 years. The women were initially divided into two groups, each with 45,000 people. In one group there were preliminary examinations of breast cancer using conventional breast scanning and in the other women an additional mammography was added. Of those who were only sampled, 505 women had died after 25 years. From the group of those who also had the annual mammography screening, 500 women had died. As the scientists wrote in the British Medical Journal, no difference was observed in breast cancer mortality between mammography and scan controls. However, the screenings were overdiagnosed by 22 percent. Treatments such as radiation, chemotherapy or surgery were unnecessary for these women.
Incorrect findings lead to unnecessary treatments This study is anything but positive for the breast cancer industry because it indirectly challenges regular screenings. Especially since a study from Switzerland came to a similarly sobering result. A few months ago, the Swiss Medical Board committee published a report on "Systematic mammography screening". Data already collected for this report was re-examined. "According to study data from the years 1963 to 1991, 1 to 2 women less of 1,000 women with regular screening die of breast cancer than in 1,000 women without regular screening," said the authors. And, like the Canadian study, the Swiss report concludes that there are too many overdiagnoses. For example, around 100 out of 1,000 women with screening “have false findings that lead to further clarifications and in some cases unnecessary treatments.” According to the report, the result is “a very unfavorable cost-effectiveness ratio.”
Positive results of the doctors On the sidelines of the cancer congress in Berlin a few days ago, those responsible drew a positive interim conclusion a good eight years after the start of the mammography screening program. In Germany, more and more breast tumors are being discovered at a prognostically favorable early stage. Overall, doctors discovered 17,501 breast cancers in 2010, when 2.7 million women accepted the mammography invitation. A weak point of the program, for which all women in Germany between 50 and 69 years are invited to mammography every two years, is still the participation rate. In this country only a little more than half of the women invited (54 percent) take advantage of the preventive medical check-up. It has only recently been reported that around every second woman is wrong or insufficiently informed when it comes to early detection or mammography screening. The health monitor of the Barmer GEK and the Bertelsmann Stiftung had shown that 30 percent of women believed that participation in mammography screening prevented them from developing breast cancer.
About 80 percent of women can be treated
According to the Robert Koch Institute (RKI), breast cancer is diagnosed in more than 70,000 women in Germany every year. About 17,000 women die of it every year. The RKI is expecting more than 75,000 new cases this year. About 80 percent of women who are ill can be successfully treated today, according to the German Society for Senology (DGS). Breast cancer is no longer synonymous with a death sentence. A lot depends on an early diagnosis. (sb)