Mammography - Risks and Benefits

Risks and Benefits

The use of mammography as a screening tool for the detection of early breast cancer in otherwise healthy women without symptoms continues to be debated. Critics point out that a large number of women need to be screened to find cancer. Kopans reminds us that since 1990, the death rate from breast cancer has decreased by almost 30% and points to studies in Sweden and the Netherlands that show two-thirds of the decrease in cancer deaths is due to mammography screening. Keen and Keen indicated that repeated mammography starting at age 50 saves about 1.8 lives over 15 years for every 1,000 women screened. This result has to be seen against the negatives of errors in diagnosis, overtreatment, and radiation exposure. The Cochrane analysis of screening indicates that it is "not clear whether screening does more good than harm". According to their analysis one in 2,000 women will have her life prolonged by 10 years of screening, however, another 10 healthy women will undergo unnecessary breast cancer treatment. Additionally, 200 women will suffer from significant psychological stress due to false posivitive results. Newman points out that screening mammography does not reduce death overall, but causes significant harm by inflicting cancer scare and unnecessary surgical interventions. The Nordic Cochrane Collection notes that advances in diagnosis and treatment of breast cancer actually may make breast cancer screening no longer effective in decreasing deaths in breast cancer, and therefore no longer recommend routine screening for healthy women as the risks might outweigh the benefits.