JAN 20, 2017 05:48 AM PST

New Study Highlights Mammogram and Overdiagnosis

WRITTEN BY: Xuan Pham

Mammography is credited for saving the lives of many women with breast cancer. Yet, while this tool is regarded as indispensible for the early detection of breast cancer, a new study found that about one-third of women for whom a mammogram turned up positive don’t actually need treatment. The study reignites the debate over whether screening actually helps or hurts patients in the end.

According to the study, published in the Annals of Internal Medicine, breast cancer screening “was not associated with a reduction in the incidence of advanced cancer.” After studying a large cohort of women aged 35 to 84 years from 1980 to 2010, the team actually concluded that one in three cases of breast cancer diagnosis led to unnecessary treatment, or what the researchers term “overdiagnosis.”

Overdiagnosis occurs when a diagnosis turns into more invasive testing and treatments that may not necessarily be needed in the first place. In the case of breast cancer, a positive mammogram would lead to tissue biopsies and follow-up testings. Some women may then also be treated with chemotherapy or radiation.

"By treating all the cancers that we see, we are clearly saving some lives," said Otis Brawley, chief medical officer of the American Cancer Society who was not involved in the Denmark study. "But we're also 'curing' some women who don't need to be cured." Brawley is referring to a subset of women with very slow-growing cancer that they may be considered almost benign.

For years, doctors and health experts have been singing the praises of cancer screening and advocating for early detection. And although medical societies, such as the American College of Radiology, acknowledge the potential for overdiagnosis with mammography, how well is this information actually communicated to patients?

Not well enough, according to Fran Visco, president of the National Breast Cancer Coalition. "Women have been inundated with the early detection message for decades," said Visco. But the other side of screening – the risks of overdiagnosis – is often obscured behind the benefits.

On the other hand, mammography remains a crucial step in saving lives. Without this technology, many women with invasive and lethal breast cancer may not be treated in time. Furthermore, mammograms only hint at a small part of the larger cancer picture. Doctors can’t determine with certainty which tumor type will be aggressive, and which type will be slow-growing. And by recommending treatment, no one can fault doctors for erring on the side of caution in their patient’s best interest.

But for now, how health professionals synthesize knowledge to make a diagnosis and recommend a treatment plan for their patients remains a fine balancing act. 

Additional sources: CNN

About the Author
  • I am a human geneticist, passionate about telling stories to make science more engaging and approachable. Find more of my writing at the Hopkins BioMedical Odyssey blog and at TheGeneTwist.com.
You May Also Like
JUN 27, 2018
Cancer
JUN 27, 2018
Engineered Poliovirus in Clinical Trials for Glioblastoma
Glioblastoma is a very difficult cancer to treat; researchers look to an engineered poliovirus for novel targeted approach for grade IV patients....
SEP 13, 2018
Cancer
SEP 13, 2018
Breast tumors can stop their own metastasis
According to the American cancer society, metastatic breast cancers or stage 4 breast cancers have 5-years survival rate of 22% which is lower than at early stages. Metastatic breast cancer...
SEP 15, 2018
Cancer
SEP 15, 2018
Undescended testicles could lead to testicular cancer and infertility in adult males
An undescended testis (cryptorchidism) is a condition in which one of the testes or both have not descended into the right position in the scrotum at birth and either stay at the abdomen or d...
SEP 26, 2018
Videos
SEP 26, 2018
Cancer Immunotherapy
Video illustration about how tumor cells are sensed and destroyed by the immune system and how tumors evolve and detect immune-mediated eliminations, as well as iimmunotherapies associated....
OCT 04, 2018
Videos
OCT 04, 2018
Zebrafish as Metastatic Cancer Model
Another Koch Institute Image Award winner from 2018 is presented in this video from MIT....
OCT 07, 2018
Videos
OCT 07, 2018
Certain Foods Encourage a Gut Microbe, and Colon Cancer
Researchers reveal more evidence that refined grains and sugars and processed meats are bad for colon health....
Loading Comments...