| Today breast cancer is the second leading cause of | | | | The team looked at the findings of studies that |
| death in women, after lung cancer. As a result, yearly | | | | spanned a 14-year period. 7 years before public |
| breast mammograms have become common for | | | | mammography screenings were available, and 7 years |
| women over 40, or anyone at high risk of developing | | | | after government run mammography-screening |
| this dangerous, disfiguring disease. | | | | programs were in place in five different countries |
| Now that programs like this are in place, experts had | | | | (United Kingdom, Canada, New South Wales, |
| expected that the number of cases of advanced | | | | Australia, Manitoba, Sweden and areas in Norway) |
| breast cancer would drop off, but that's not | | | | They found an over-diagnosis rate of 52% for all |
| happening. | | | | cancers, 35% for invasive breast cancer. |
| Instead the incidence of breast cancer seems to | | | | The data shows a jump in breast cancer incidence |
| have gone up since widespread screening became | | | | just after the screening programs were put in place. |
| part of our yearly exams. Why? | | | | What this work suggests, as did the Norwegian |
| Women know that early detection of breast cancer | | | | study before it, that perhaps not all cancers need to |
| can save lives, but that doesn't make going for that | | | | be treated, some might grow too slowly to affect a |
| yearly mammogram any less nerve wracking or | | | | patient and others may resolve on their own. |
| uncomfortable. | | | | It's important to know that no doctor or current |
| We endure the testing because we've been told we | | | | screening technique can tell the difference between a |
| need to find lumps when they're too small to feel or | | | | cancer that's dangerous and one that might not be. |
| bring symptoms, before they have a chance to grow | | | | In a BMJ editorial that's published along with the |
| and cause trouble. | | | | research, professor of medicine Dr. H. Gilbert Welch |
| But do all cancers cause problems? | | | | of the Dartmouth Institute for Health Policy and |
| Late last year a large Norwegian study of | | | | Clinical Research recognizes the problem of |
| mammography screening for breast cancer found | | | | over-diagnosis, understanding the trauma and terror a |
| that some invasive cancers might spontaneously | | | | woman endures after being given such news by her |
| regress over time, leaving no sign that they were | | | | doctor. |
| ever present in a woman's body. | | | | Surgery and chemotherapy bring their own set of |
| Makes you wonder, now that we can screen for it, if | | | | difficulties that are physically demanding and |
| this type of cancer isn't over diagnosed or over | | | | emotionally draining, and a terrible trial for patients |
| treated. | | | | and families. Especially those whose cancers might |
| This latest BMJ report citing an over-diagnosis rate | | | | not have needed to be treated at all. |
| for invasive breast cancer of 35% could truly have | | | | While this latest study is still not an excuse, or |
| you re-thinking that yearly mammogram. | | | | recommendation, to put off your yearly |
| Besides this type of cancer, over-diagnosis has also | | | | mammogram, it does raise some rather nagging |
| been mentioned for cancer of the prostate as well | | | | questions. |
| as neuroblastoma, melanoma, thyroid cancer and lung | | | | Until we know more, each woman has to decide for |
| cancer. | | | | herself whether to continue with yearly breast |
| The latest work on over-diagnosis comes from | | | | mammograms, but it is clear that screening has let us |
| researchers out of the Nordic Cochrane Centre in | | | | detect earlier cancers and start treatment earlier. |
| Copenhagen. | | | | |