Breast Cancer Screening Recommendations Revisited

Breast Cancer Screening Recommendations Revisited

Are you confused about breast cancer screening recommendations? If you are, you are not alone.

Multiple organizations have come out with conflicting studies, data, and recommendations. Those advocating for reduced screening argue that screening does not improve the death rate from breast cancer; that women who have biopsies that are found to be benign suffer significant psychological harm; and that cancers are found that would never cause death.

Significant flaws have been found in these arguments by physicians who have committed their careers to understanding and treating breast cancer. There are multiple problems with the scientific methodology, assumptions, endpoints and analyses used in these critiques of mammogram screening recommendations. One problem is that medical science currently does not have the ability to distinguish between lethal cancers and those that will not cause death. Based on rigorous scientific data, we do know that the best way to improve survival from breast cancer is to detect it before it becomes clinically obvious and to treat it early.

None of the major oncology organizations support the guidelines calling for reduced screening. A letter to the New England Journal of Medicine, signed by the presidents of a large number of professional societies involved in the diagnosis and treatment of breast cancer, states:

“A large body of scientific knowledge on screening mammography has been gained through rigorous outcomes research on millions of women. Eight prospective randomized trials and multiple large population based reports have consistently shown the same result – a statistically significant reduction in mortality from breast cancer of 25 – 30% with the use of screening mammography. The benefit is even greater among women who actually participated in screening compared with the group of women who were invited to screening.”

While physicians at the Swedish Cancer Institute are all concerned with responsible utilization of precious medical resources, none of us want to see more women presenting with later stage breast cancers requiring more extensive surgical treatment, requiring chemotherapy that may have been avoided, and having an increased risk of dying from breast cancer. To that end, all the medical specialty groups at the Swedish Cancer Institute recommend ongoing screening mammography for women every year starting at age 40. If you have any questions about these recommendations, please use the comment section below to ask.

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