Health Official: Routine Mammograms May Lead To Overdiagnosis

BOSTON (CBS) – A local health official’s research suggests that routine mammography screening, long viewed as an essential tool in detecting early breast cancer, may be causing a significant amount of overdiagnoses of the disease that would otherwise prove harmless.

WBZ NewsRadio 1030’s Diane Stern spoke with Dr. Mette Kalager:

The report was based on a study of women in Norway, where the researchers estimated that between 15% and 25% of breast cancer cases are overdiagnosed.

“We have to look at both the harms and the benefits of mammography screening to get anything out of this,” said Dr. Kalager from the New Harvard School of Public Health (HSPH).

What is the harm of overdiagonsis?

Most women in the U.S. begin getting their annual mammograms when they are in their 40’s or 50’s. But, recent research suggests evidence of overdiagnosis has increased debate about the benefits of screening.

There have been a number of experts that have speculated that new effective treatments for breast cancer play a larger role in saving women’s lives than screening does. They have also noted that overdiagnosis can cause unnecessary emotional stress and unnecessary medical treatment.

“Overdiagonsis means that you are diagnosed with a cancer that would never appear clinically or you will not experience symptoms or would kill you,” said Kalager. “So you are treated with surgery, with chemotherapy, with radiation, and with hormone treatment, without any benefit from it.”

Kalager says the new findings suggest that women now should be informed about the potential benefit from mammography, but also the many different harms that can come with it, including mental distress, biopsies, surgeries, or chemotherapy and hormone treatments for disease that would never have caused symptoms.

The researchers have come to the conclusion that if mammography is beneficial, it would lead to a decrease in late-stage breast cancer cases—the theory being that early detection prevents late-stage disease.

However, the researchers did not find a reduction in late-stage disease in women who had been offered screening. Instead, they did find a substantial amount of overdiagnosis.

Among the 7,793 women diagnosed with breast cancer through participation in the screening program, the report found 15% to 25% were overdiagnosed (between 1,169 and 1,948 women).

Based on those numbers, officials further estimated that, for every 2,500 women invited to screening, 2,470 to 2,474 will never be diagnosed with breast cancer and 2,499 will never die from breast cancer.

More from Diane Stern
  • Willow

    In my opinion, mammograms should continue as they have, and perhaps the diagnosis be studied longer and modified.

  • Scooby

    If you have a mammogram & it detects even the smallest amount of cancer then all remedies available should be made to remove the cancer from ones body. Cancer can change slowly or quickly. WHY take the chance?!?!

  • Pat

    I was diagnosed with breasts cancer stage 1 grade 2 in September 2011. I was treated with lumpectomy and radiation. It has also been recommended that I take Femara which serves to eliminate estrogen from your body. My risk of reoccurrence is 15% which the drug would reduce to 7.5%. I have struggled mightily with this decision because of the side effects of this medication, specifically bone loss. My oncologist informed that most woman don’t challenge these recommendations which I feel is very unfortunate. This study is very important in our need to be well informed about treatment recommendations and to not simply follow doctors orders.

    • Scooby

      Pat, I sincerely hope you do well with your treatment whatever treatment you decide is best for you. My sister-in-law is going through this right now as well.
      A lot of people (male or female no matter what the medical condition is) will follow whatever their doctor says (like sheep) without getting a second opinion. That is a shame. That being said, I think that any cancer that is found should be taken care of right away. Whatever treatment one decides on is right for them along with their doctor.

  • tata8

    Agreed with the above comments. I didn’t see where the article stated who is funding this research. I can’t help but wonder if it could be somehow related to someone in the insurance industry. Sounds like a similar argument to the recent pap cutback “guidelines.” … what, if they can prove annual screenings aren’t bringing down late-stage numbers, then why bother? Hmmm,… I just hope it’s not THEIR mothers, wives, friends who find they are diagnosed late stage in a 1-2 year gap between mammos or paps.
    I completely agree that we should all be well informed about treatment options, side effects, and tradeoffs… although I’m still unclear how it’s better to save the “mental distress” for potentially discovering cancer late stage vs. catching and treating it early…. through annual screening.

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