According to a recent article published in The Lancet, results from clinical trials involving nearly 250,000 women indicate that mammography may play an important role in reducing deaths caused by breast cancer.
Breast cancer is a common malignancy, with over 200,000 cases diagnosed each year in the United States. Since breast cancer is curable in its early stages and becomes more difficult to treat as it progresses, researchers have focused efforts on screening and prevention strategies.
Screening with mammography has been utilized for early detection of breast cancer for many years. However, the value of mammography has recently been under attack as some researchers questioned whether the screening procedure resulted in improved survival. In addition, one drawback of mammography is the possibility of a false-positive reading. A false positive reading indicates the possibility of breast cancer when it does not actually exist which may result in an unnecessary biopsy and patient anxiety. As a results of the controversy, researchers recently updated results from several Swedish clinical trials evaluating mammography screening through 1996. In these trials, approximately 130,000 women received annual mammography screening and approximately 120,000 women did not receive mammography screening (control group) for the detection of breast cancer. The two groups of women were the directly compared.
The average time to initiation of the trial to the end of follow-up was 15.8 years. Overall, there was a 21% reduction in breast cancer mortality in the patients who underwent mammography screening. The reduction in breast cancer death was greatest in the age group 60 – 69 years (33%) and least in patients aged 50 – 54 years at the beginning of the trial. The results of these trials clearly indicate that screening mammography reduces mortality from breast cancer through early detection.
These updated results may help to lay to rest the doubts about the relative effectiveness of mammography screening. Furthermore, the U.S. Preventive Services Task Force (USPSTF) recently announced updated recommendations for breast cancer screening that addressed the controversy. The USPSTF recommends mammography, with or without clinical breast examination, every one to two years for women ages 40 and over. In addition, the U.S. Department of Health and Human Services (HHS) and the National Cancer Institute also reaffirmed the value of mammography. Individuals 40 years of age or older and/or those at a high risk of developing breast cancer may wish to speak with their physician about the risks and benefits of yearly mammography screening. (Nystrom L, Andersson I, Bjurstam N, et al. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. The Lancet. 2002;359:909-919.)
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