Useless Medicine: Mammogram Procedure

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Filed Under: Useless Medicine
Last Reviewed 02/16/2014

Useless Medicine: Mammogram Procedure

Are you confused about whether to have a mammogram procedure? Join the crowd. Everywhere you turn, there’s conflicting information about mammography screening.

The American Cancer Society says one thing, and the U.S. Preventive Services Task Force (USPSTF) says another. Bureaucrats and politicians—who have no medical background whatsoever but are eager to appease—join the fray with impassioned pronouncements about the mammogram procedure.

What get lost in all this noise are the hard facts. Let’s look at some of the latest scientific research on routine mammography screening.

Mammogram Procedures Lead to Overdiagnosis and Overtreatment

The Cochrane Collaboration, a well-respected international organization that examines the science behind various medical interventions, reviewed seven randomized clinical trials (involving 600,000 women) that compared mammogram procedures with no screening. They discovered:

  • Three studies showed that routine mammography screening did not significantly reduce the death rate.

  • Four studies, which the researchers said had “suboptimal randomization” (a design flaw), showed a significant reduction.

  • The combined data revealed that routine mammogram procedures conferred a 15 percent reduction in risk of death. But it also led to 30 percent overdiagnosis and overtreatment, and the absolute risk reduction was just 0.5 percent.

The researchers concluded, “It is thus not clear whether screening does more good than harm.”

Other Problems Associated With a Routine MammogramProcedure

Routine mammography screening also has a dark side. There is significant radiation exposure, which adds up with an annual mammogram procedure and may itself increase risk of cancer:

  • For every 100 women screened, 10 will be told their mammograms are suspicious and that they need additional testing.

  • A woman who has a mammogram procedure every year for 10 years has a 65 percent chance—more than 1 in 2—of having at least one false positive.

Emotional trauma aside, this opens the door for biopsies and other tests, as well as treatment of tumors that would never amount to anything.

The Cochrane group reported that significantly more of the women who had mammogram procedures had lumpectomies and mastectomies. The knee-jerk reaction is to assume that these procedures saved lives. Ask any woman who has undergone a lumpectomy or mastectomy, and she’ll likely agree.

But she may well have had an “indolent” cancer, which studies suggest frequently regress and disappear on their own. These are the tumors that are far more likely to get picked up on a yearly mammograscreening procedure, not the aggressive, rapidly spreading cancers that are responsible for most breast cancer deaths.

Benefits of the Mammogram Procedure: Consider Your Age and Symptoms

Research has also found that routine mammography screening for women who are in their 40s or older than 75 has not been demonstrated to provide significant benefits.

As a result, in 2009, the USPSTF updated its mammogram procedure guidelines, stating that mammography should begin at age 50, not age 40, through age 74. It also recommended that women have mammograms every two years, rather than annually.

While I agree with the USPSTF recommendations, you should also consider whether you have symptoms. For asymptomatic women between the ages of 50 and 74, benefits of mammography screening are scant, and in my opinion, are outweighed by the risks of overdiagnosis and overtreatment.

Your Decision Should Be Based on Facts, Not Fear

Am I telling you not to have a mammogram procedure? No. But I am telling you that the evidence of benefit is slight to nonexistent and in no way warrants the scare tactics that are widely used.

Even Otis Brawley, the Chief Medical Officer of the American Cancer Society, said, “We don’t want people to panic, but I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”

The bottom line: Do your research and make your own decision about a mammogram screening based on facts, not fear.

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