Breast Cancer | 07/13/2009 9:40 am
Study: 1 in 3 Breast Cancer Cases Diagnosed From Screenings Are False Alarms
Good news or not? Overdiagnosis often is accompanied by unnecessary surgery for cancers that will never grow.
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We’ve got some news about breast cancer — but whether we can call it "good" … well, you read and decide for yourselves.
A new study in the British Medical Journal says about one in three breast cancers detected in public mammography screening programs in several countries is overdiagnosed, meaning that one in three women told they may get cancer won’t, or, if they do, it won’t kill them. "Screening" is an X-ray looking for cancer before a person has any symptoms, and it can help find cancer at an early stage, making it easier to treat. The National Cancer Institute says scientists are trying to better understand which people are more likely to get certain types of cancer, so they study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used and how often the tests should be done.
For the BMJ study, doctors analyzed how breast cancer rates changed after publicly organized screening programs were introduced in the UK, Canada, Australia, Sweden and Norway. A spike in breast cancer rates was found in each country that was closely associated with the introduction of screening for women beginning at age 50. On its face, this may sound good. But the study also found that mammograms save one life for every ten cancers that are diagnosed and treated unnecessarily. "What this means is that mammograms lead to far more unnecessary surgeries and chemotherapy treatments than saved lives," writes Deborah Kotz of U.S. News and World Report.
Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Research, who wrote an editorial to the BMJ study, says:
With the advent of widespread efforts to diagnose cancer earlier, overdiagnosis has become an increasingly vexing problem. Overdiagnosis is a widely recognized problem in prostate cancer screening, and it has also been reported in other cancers, including neuroblastoma, melanoma, thyroid cancer and lung cancer. Some degree of overdiagnosis is likely to be the rule rather than the exception in cancer screening … Mammography is one of medicine’s ‘close calls’ — a delicate balance between benefits and harms — where different people in the same situation might reasonably make different choices. Mammography undoubtedly helps some women but hurts others. No right answer exists, instead it is a personal choice.
Read more about: BMJ, Breast Cancer, British Medical Journal, Cancer, Cancer Screenings, Diagnosis, Health, Mammography, News, U.S., World
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21 Reader Comments (so far…) Sign In or Register to comment
Oh, Judy, I know it must be tough. He lost one salivary gland but all you need is one so his mouth is not dry anymore. He had to have beautiful molars removed on the one side in preparation for the treatment. He, too, has rosacea…comes and goes. There is a shingles shot now being given to those over age 60. If you haven’t had one you might want to look into it. He lost a tremendous amount of weight, too. Had to have a radical tonsillectomy, then the stomach tube, then the horrendous treatment in the "Jason" mask laced three times during the 7 weeks with 24 hour chemo. It took a long time for his "taste" to correct itself but finally he got that back. The surgery afterwards had him on the operating table for nine long hours. It challenged a muscle in his shoulder so his shoulder isn’t as strong as it use to be but he does exercises regularly. It’s for sure you aren’t the same after treatment that takes you to the brink of death but it is, indeed, better than the alternative.
Hang in there. And best wishes to you for a complete recovery from the side affects.
His treatment started in June 2006 and he had his surgery in October 2006. It took almost a year for his taste to come back. I most sincerely hope your doctors can find something to boost your immune system. I know each situation is different depending on many things but I do know if we had it to do over we would do it the same way. Even the surgery which was left entirely up to him. We felt like if you are holding the football on the 5 yard line you need to at least try to score.
Again, thank you for discussing this with me. For me, it was the hardest thing I’ve ever had to deal with in my entire life. Sometimes the patient has it easier than the caregiver in terms of the emotional side of it. We’ll probably have all of this deleted because we are off topic but I enjoyed our exchange.
That is very good advice and I would like to add that head and neck cancers are sometimes hard to detect. Dentists now do an oral cancer exam when you have your teeth cleaned, etc. My husband actually went to his dentist and a month later to an oral surgeon for a root canal. Both missed the cancer. His particular cancer was large and dislodged his right tonsil. He never knew he had it…no cough, etc. I noticed a small lump on his neck. I asked him to make an appointment to have it checked. He went to the ENT they gave him antibiotics and sent him home. He took the drug the lump went away. Two weeks later it was back. Back to the ENT. The ENT sent him immediately to a surgeon who did a biopsy within two weeks. The biopsy came back negative. The surgeon called him and said, "I need for you to come in tomorrow." In he goes and the surgeon said, "I believe you have cancer but I don’t know where it is. I want to do exploratory surgery on you as soon as possible." We were in shock.
He went into surgery and he found a stage 3 on his right tonsil which had gone into one lymph node (the lump on his neck). He performed a radical tonsillectomy and the rest is history.
No symptoms, biopsy came back negative. Had not that over confident Naval Captain surgeon at the Naval Hospital "cared" I believe my husband would not be alive today. He had a fast growing cancer and we caught it just in time.
So, the best thing you can do for yourself is to pay attention to your body and your spouse’s/partner. Head and neck cancer usually affects men around 55 years old. In women it is rare. However, something else is going on with this cancer as it is showing up now in younger men and more women. It use to be that this cancer came from heavy smoking and drinking but it is now appearing in people who have never smoked or consumed alcohol and this particular cancer is on the rise. Being in the navy for 30 years and on an aircraft carrier, flyer, etc, I still think it was related to jet fuel as he doesn’t smoke or drink heavily. No one can be sure now where it comes from but there is an interesting study you can research if you are interested. We are just glad it is over and he has recovered. He is a wonderful human being.
Be safe, everyone, check your body and please go to a dermatologist once a year to get a full body check for skin cancer. And, lastly, self breast examination. If it feels the slightest bit different from the time before it is time to make an appointment with your doctor. Early detectin is critical.
Thanks for your advice, Judy! We need all the information we can get.
I’m sooo glad your doctor found it in time. Bravo, Judy! All cancers are serious but the head and neck is particularly difficult because the treatment affects so many delicate areas that we rely on to eat, drink, swallow and speech.
This speaks to the same old issue. Do we want doctors or big corporations making decisions about our health care when we truly are quite ill? Reform is needed so badly on so many fronts.
Here is where it is most problematic for so many patients who consider their health insurance to be more than adequate. Perhaps a woman is diagnosed with breast cancer, and that diagnosis is correct. That in itself is past horrifying. But then consider her panic when she learns her insurance has been dropped. This happens often.
Insurance companies comb carefully through medical records looking for any small error that will allow " rescission"… and they use that small error as the sole reason to drop insurance altogether or deny certain procedures.
To put it another way, whether it is breast cancer or any other serious illness, health care needs are not being met in favor of profitability… even when a life hangs in the balance.
One issue Congress and this adminstration support ( along with the AMA) is a national code of conduct for health insurers with clear and concise medical policies and payment issues. The bottom line issue is to make certain that the integrity of doctor/patient relationships can no longer be compromised by the insurance companies.
That certainly seems worthy of Americans’ support.
What we need are better scans. I’m not convinced that mammography is enough. I have friends who were overtreated for breast cancer. I realize the history factor dicatates the seriousness of the treatment. No one in my family has had it even back four generations but it can happen dispite this.
I do know that if I were diagnosed with breast cancer I would go to the best cancer treatment known to successfully treat breast cancer for a thorough evaluation and then weigh my options.