The medical community has been a strong proponent of using screening mammography procedures for thirty years now – and that gives researchers a considerable amount of data from which to draw conclusions. Despite some back-and-forth recommendations regarding the frequency of the testing, and at what age women should begin an annual mammography, the practice is so widespread that an analysis of results is pretty meaningful.

Keep in mind that the initial idea was to identify breast cancer at an earlier stage so it could be more treatable, and to hopefully decrease the number of late-stage initial diagnoses, thereby saving lives. Whenever effective screening programs are put in place, one result is a much higher detection rate, which can be alarming, but finding more cancers earlier is ultimately part of the goal. Eventually, medical ethics require that some thought be given to whether all of the impact of the testing itself has been “worth it” based on the outcomes achieved.

Since 1976, when screening mammography was introduced for women over 40, the detection rate for early-stage breast cancer has doubled – from 112 to 234 cases per 100,000 women. At the same time, the incidence of late-stage cancer has decreased, but only by eight percent, from 102 to 94 cases for the same size group. This vigilance in screening has also created a new dilemma. Mammographic screening has uncovered large numbers of tumors that are not, and would likely never become, cancerous. Roughly 1.3 million women – representing 31% of all breast cancers diagnosed – fall into that category.

Scientists have concluded that even though there have been substantial increases in the detection of early-stage breast cancer, the lack of a significant reduction in finding advanced stages of the disease has been disappointing. Add to that the substantial number of “false alarms” and the bottom line is that screenings have had a small effect, at best on the rate of death from breast cancer. Somehow the paradigm needs to be shifted; new techniques developed, and underserved populations screened, so we can make a consistent and meaningful impact on breast cancer mortality.


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