Dr Donald Decker | Breast Cancer Screening | Rolling Oaks RadiologyAccording to the American College of Radiology and Society of Breast Imaging, the recent breast cancer screening article (Miller, et al) published in the British Medical Journal (BMJ) is an incredibly misleading analysis based on the deeply flawed and widely discredited Canadian National Breast Screening Study (CNBSS).

The results of this BMJ study, and others resulting from the CNBSS trial, should not be used to create breast cancer screening policy, as this would place a great many women at increased risk of dying unnecessarily from breast cancer.

So, you may be asking: What should women do with this information?

They should ignore the information from this most recent published analysis of the CNBSS trial. Many experts have stated that the trial was poorly designed and executed, and the data, therefore, corrupted. Analysts need to be honest and stop citing this trial as having any validity.

Every major American medical organization with expertise in breast cancer care, including the American Congress of Obstetricians and Gynecologists, American Cancer Society, American College of Radiology, National Accreditation Program for Breast Centers and Society of Breast Imaging recommend that women start getting annual mammograms at age 40.

But, you may again be asking: Why is the recommendation to start at age 40?

Breast Cancer Screening | Rolling Oaks RadiologyAccording to National Cancer Institute data, since mammography screening became widespread in the early 1990’s, the U.S. breast cancer death rate, unchanged for the previous 50 years, dropped by over 30 percent. By not getting a yearly mammogram after age 40, women increase their odds of dying from breast cancer, and treatment for any advanced cancers ultimately found will be more extensive and more expensive.

The largest (Hellquist, et. al) and longest running (Tabar, et. al) breast cancer screening studies in history further confirms that regular mammography screening cuts breast cancer deaths by roughly a third in all women ages 40 and over (including women ages 40-49).
A recent study (Otto, et. al), published in Cancer Epidemiology, Biomarkers & Prevention, shows mammography screening cuts the risk of dying from breast cancer nearly in half.

While there is always a need for controlled studies about the risks and benefits of any screening program, we continue to believe there is great benefit for an annual mammographic screening program for women beginning at age 40. Mammography can detect cancer early when it’s most treatable and can be treated less invasively – which not only save lives and reduces medical costs, but also helps preserve quality of life.

For more information regarding the proven effectiveness of regular mammography screening at reducing breast cancer deaths, please visit MammographySavesLives.org.

If you have any questions or concerns regarding evidence based recommendations for breast cancer screening and imaging strategies, please feel free to call Rolling Oaks Radiology and ask to speak to our experienced women’s imagers.

Mammography Saves Lives

Breast Cancer Screening — Selected Sources for Review:

  • Baines CJ, Miller AB, Kopans DB, et al. Canadian National Breast Screening Study: assessment of technical quality by external review. AJR 1990;155:743-747.
  • Kopans DB. The Canadian Screening Program: A Different Perspective. AJR 1990;155:748-749.
  • Kopans DB, Feig SA. The Canadian National Breast Screening Study: A Critical Review. AJR 1993;161:755-760.)
  • Tarone RE. The Excess of Patients with Advanced Breast Cancers in Young Women Screened with
  • Mammography in the Canadian National Breast Screening Study. Cancer 1995;75:997-1003.
  • Nickson C, Mason KE, English DR, et al. Cancer Epidemiol Biomarkers Prev 2012;21:1479-1488. Published online September 5, 2012.
  • Hellquist et al. Evaluation of the Swedish Mammography Screening in Young Women (SCRY) Cohort. Cancer February 15, 2011.
  • Hellquist et al. Overdiagnosis in the population-based service screening programme with mammography for women aged 40 to 49 years in Sweden. J Med Screen 2012:1–6 DOI: 10.1258/jms.2012.011104.
  • Kopans et al. Mammographic Screening and “Overdiagnosis.” Radiology: Volume 260: Number 3—Sept. 2011.
  • Schousboe et al. Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness. Annals of Internal Medicine. 2011 Jul;155(1):10-20