Good prognosis through mammography screening

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Cooperative Mammography presents evaluation of the Europe-wide mammography screening

At the Cancer Congress in Berlin, the mammography cooperation group presented a Europe-wide evaluation of the mammography screening. According to this, many tumors with a size of less than two centimeters are discovered during the examination. This tumor stage is considered prognostically favorable if the lymph nodes are not affected. Critics complain, however, that on the one hand too few women are saved by screening and on the other hand too many women endure unnecessary therapies.

Evaluation of first and follow-up examinations of the mammography screening for the first time Within a year, about 17,500 breast cancers were discovered by breast cancer screening. Many could be discovered at a very early stage with good chances of a cure, reports the mammography cooperation group. Since the introduction of the comprehensive program in Germany in 2009, not only the initial examinations but also the follow-up examinations have now been taken into account for the 94 screening units with around 400 locations. "The data from 2.7 million examinations have been evaluated for the current annual report," reported Dr. Karin Bock from the Reference Center Mammography Southwest. The most significant are the results of the follow-up examinations. "The trend of previous years is clearly confirmed. 80 Percent of invasive carcinomas are smaller than two centimeters and 78 percent have not yet affected the lymph nodes. " These small tumors have a much more favorable prognosis than larger ones, which also affect the lymph nodes. "We are now certain that German screening is on the right course," explained the head of the Mammography Association, Dr. Tatjana Heinen-Kammerer.

Effects of mammography screening on breast cancer mortality and quality of life It is not only the tumor stage distribution that shows that early breast cancer detection works in Germany. “The screening does what it should. We can also see this in comparison with the current data from the cancer registry, "reports Professor Alexander Katalinic from the Institute for Social Medicine and Epidemiology at the University Medical Center Schleswig-Holstein." First of all, the new breast cancer diseases increase due to the screening, because additional tumors can be found at an earlier stage ". After that, the rate usually drops because the cases discovered in the first screening run are missing in the following. According to the mammography cooperation group, the changes in tumor stage distribution and the increase and decrease in new cases are the first measurable effects of a breast cancer screening program. However, it was only after nine to twelve years that statements could be made as to whether the screening would also reduce breast cancer mortality, the experts said. "In Germany, we will not be able to say anything about it until 2018 at the earliest," emphasized Katalinic. "We are discussing a lot about breast cancer mortality. The 5-year survival rate has risen steadily over the past few years to 87 percent. We should therefore find the influence of screening by finding it prognostically cheaper carcinomas on the quality of life much more than before as an evaluation factor. "

Criticism of mammography screenings Again and again voices are voiced that express criticism of mammography screenings. According to some studies, the study of few women saves lives. At the same time, many women undergo unnecessary therapies such as radiation or chemotherapy due to findings that are usually negligible. Some health experts even advise against screening programs.

A recent study by the Bertelsmann Foundation and the Barmer GEK showed that many women in Germany are very poorly informed about the benefits of mammography screenings. According to the "Health Monitor", 30 percent of women believed that participation in breast cancer screening alone prevented them from developing malignant tumors. The experts came to the conclusion that, on the one hand, the benefits of the investigation are overestimated, and on the other hand, there is little knowledge about the risks, such as false positive findings. Many women are extremely afraid of making wrong decisions when it comes to diagnosing cancer, the authors of the report write. Professor Norbert Schmacke, who was involved in the investigation, considers the extent of the information deficit to be worrying. In his opinion, there was a lack of understandable information and the time and opportunity to form one's own opinion, especially in the screening invitations.

According to the mammography cooperation group, eight of 1,000 women are diagnosed with breast cancer during the initial screening in mammography screening. In the following run it was 5.5. According to the Robert Koch Institute (RKI), 70,000 women develop breast cancer annually, and around 17,500 die from it. The risk of developing breast cancer increases with age. (ag)

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