Breast Cancer Screening: How Komen Oversold the Benefits of Mammography

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The breast cancer advocacy group, Susan G. Komen for the Cure — which famously introduced the world to the pink ribbon — used misleading statistics in an advertising campaign to overstate the benefits of mammography, while ignoring its risks, say researchers publishing in the BMJ.

Breast cancer screening has sparked ongoing debate over the last few years, particularly since 2009 when the U.S. Preventive Services Task Force (USPSTF) rolled back its breast-cancer screening guidelines, advising against routine mammography for women in their 40s, and instead recommending screening every other year for women starting at age 50. The guidelines were based on data showing that routine mammograms may cause more harm than good in younger women, leading to overdiagnosis, aggressive overtreatment, undue stress and complications.

(MORE: Study: For Some Women in their 40s, Routine Mammograms May Be Worth the Risks)

Still, the American Cancer Society continues to recommend annual mammograms for women in their 40s, and many women choose to adhere to a similar screening schedule. But many have lingering questions about the risks and benefits of screening, and getting reliable data can be tricky. Many women look to their doctors, who aren’t always up on the most recent data, or to well-known breast cancer charities like Komen.

Last year, Komen ran an ad for mammograms urging women to “get screened now” because “early detection saves lives. The 5-year survival rate for breast cancer when caught early is 98%. When it’s not? 23%.”

The numbers suggest that women “would have to be crazy” not to get screened, say the authors of the editorial in the BMJ, Lisa Schwartz and Steven Woloshin of the Center for Medicine and the Media at The Dartmouth Institute for Health Policy and Clinical Practice. “But it’s the advertisement that’s crazy,” they say, because its presentation of data wildly misrepresents the true mortality benefits of screening and fails to address the potentially serious risks.

“Komen’s public advertising campaign gives women no sense that screening is a close call. Instead it simply tells women to be screened, overstates the benefit of mammography, and ignores harms altogether,” they write.

(VIDEO: Pink Light: Burlesque and Breast Cancer Survivors)

Say, for instance, 100 women receive diagnoses of breast cancer at age 67, not through screening but because they detect a breast lump. Assume they all die at age 70; five-year survival for this group would be 0%. Now, say the women were screened and given their cancer diagnosis three years earlier, at age 64, but they still die at age 70. Five-year survival is now 100%, even though no one in the screening group lived any longer.

“Five-year survival is all about what happens from the time of diagnosis: it is the proportion of women who are alive five years after diagnosis. Because screening finds cancers earlier, comparing survival between screened and unscreened women is hopelessly biased,” the authors write.

When you look at the actual life-saving benefits of screening — not by judging five-year survival rates, but by comparing overall death rates in women at various ages who get screened or don’t get screened — the numbers are a lot less compelling. For example, women in their 50s who get routine mammography will reduce their odds of death from breast cancer over the next 10 years from 0.53% to 0.46% — a difference of 0.07 percentage points.

But “mammography certainly sounds better when stated in terms of improving five-year survival — from 23% to 98%, a difference of 75 percentage points,” the authors note.

(MORE: Higher Risk for Women With False-Positive Mammogram Results)

Early detection can also distort five-year survival rates, Schwartz and Woloshin argue, because it can catch small tumors that would never have caused symptoms or killed patients to begin with; some tumors grow extremely slowly or not at all. By diagnosing these women, you’re including patients who will by definition survive, thereby inflating five-year survival statistics even though the screening itself didn’t actually save lives.

“If there were an Oscar for misleading statistics, using survival statistics to judge the benefit of screening would win a lifetime achievement award hands down,” the authors write.

Further, the Komen ad fails to address the harms of screening, the authors note:

Between 20% and 50% of women screened annually for a decade experience at least one false alarm requiring a biopsy. Most importantly, screening results in overdiagnosis. For every life saved by mammography, around two to 10 women are overdiagnosed. Women who are overdiagnosed cannot benefit from unnecessary chemotherapy, radiation, or surgery. All they do experience is harm.

“Everyone agrees that mammography isn’t perfect, but it’s the best widely available detection tool that we have today,” said Chandini Portteus, vice president of research, evaluation and scientific programs at Susan G. Komen, in a statement [PDF]. She acknowledges that “science has to do better,” which is why the charity is putting millions of dollars toward early detection research and toward studies designed to help doctors identify which tumors will spread and which won’t. “While we invest in getting those answers, we think it’s simply irresponsible to effectively discourage women from taking steps to know what’s going on with their health.”

(MORE: Ultrasounds and MRIs Detect More Breast Cancer, Study Says)

Indeed, few doctors would disagree that mammography has benefits. The problem is that those benefits are often overstated. “Women need much more than marketing slogans about screening: they need — and deserve — the facts,” the authors conclude. “The Komen advertisement campaign failed to provide the facts. Worse, it undermined decision making by misusing statistics to generate false hope about the benefit of mammography screening. That kind of behavior is not very charitable.”

13 comments
Nadine
Nadine

 

Who says a “MEDICAL” cure is the answer?

 

PINK RIBBONS, INC. - A CONVERSATION WITH FILM DIRECTOR RAVIDA

DIN

 

http://youtu.be/CkpwfqF4WO0

 

 

…………………..

Nadine
Nadine

 

When she was first pitched the project by National Film

Board of Canada producer Ravida Din, she says she had little knowledge of the

pink ribbon beyond its role as a fundraising and awareness tool.

 

Din encouraged her to read Samantha King's book "Pink

Ribbons Inc.: Breast Cancer and the Politics of Philanthropy" and Barbara

Ehrenreich's searing 2001 Harper Magazine article "Welcome to

Cancerland," each of which question the motives of corporate-backed

campaigns.

 

http://www.winnipegfreepress.c...

 

……………………..

Nadine
Nadine

 

Pink Ribbons, Inc.

 

This film paints a shocking portrait of how the pink ribbon

campaign benefits businesses more than women with breast cancer.

 

In the National Film Board of Canada feature documentary

Pink Ribbons, Inc., director Léa Pool talks to women with breast cancer,

experts, authors, activists and medical researchers, as well as the leading

players in breast cancer fundraising and cause-related marketing, to paint a

shocking portrait of how the pink ribbon campaign benefits businesses more than

women with breast cancer.

 

http://youtu.be/3QPZfcYTUaA

 

………………………….

Manhattan LASIK Center
Manhattan LASIK Center

@Talendria:disqus , I'm glad your mother is alright! If you notice something strange during a 

palpation  check, don't hesitate to take a mammography test.

Killroy71
Killroy71

This is the real "war on women," scaring us into horrendous procedures that mutilate body and spirit. SGK spends way more on its own self-perpetuating activities than it spends on research.  That became clear after the whole Planned Parenthood fiasco. I've never worn a pink ribbon and never will.

Talendria
Talendria

My mother spent much of her forties worrying about breast cancer.  She had two false positive mammograms that led to biopsies and was told she had fibrous breasts.  She stopped getting mammograms altogether because the experience was so unpleasant and ultimately pointless.  She developed breast cancer in both breasts at age 60 and discovered it through palpation (self-exam).  It was stage one and easily treated, and she's been cured or in remission for twelve years.  

In my mother's case, mammography offered no benefit and actually caused a great deal of stress as well as two unnecessary medical procedures.  Now that I'm 40, I can't decide whether to jump on the mammogram bandwagon.  I'd feel silly for not taking advantage of every health resource at my disposal, but I'm not convinced that irradiating my chest every year is going to improve my longevity.

Pat McCord
Pat McCord

I stopped supporting Susan G. Komen years ago when I realized that they are not looking for a cure so much as looking for pharmaceuticals.  There are many promising alternative treatments that never get studied by this money machine.  SGK has become big business.  My friend found her lump by thermal imaging, and a year later it was gong-no radiation.

DennisKnicely
DennisKnicely

According to article: "the U.S. Preventive Services Task Force (USPSTF) rolled back its breast-cancer screening guidelines" since 2009, after this article came out explaining in detail the facts:  http://www.BreastHealing.info  .  Read it then come to your own conclusions.  I believe many conventional medical protocols will be refuted, with many present day practices regarded as "barbaric mutilation" once the masses realize environmental, nutritional and other ways that can reverse chronic illness are often very successful with some discipline, instead of dangerous, life threatening treatments.

Lee Cox
Lee Cox

In my previous post, I miss stated the amount of money Komen donated to Planned Parenthood.  It should have read hundreds of thousands of dollart, et.....

Lee Cox
Lee Cox

I quit donating to Komen after it was revealed that they donated hundreds of dollars to Planned Parenthood.  Although Komen said that no money went for abortion, they must think we're stupid to not know the money is fungible, and can be used by PP anyway they want.  Komen is like every other scam.  Once the ball gets rolling it's almost impossible to stop.

ElsieyeyVieri
ElsieyeyVieri

Charlotte responded I'm amazed that a mother can earn $4145 in a few weeks on the network. did you see this(Click on menu Home)

ChampionPinkVaccine
ChampionPinkVaccine

I agree Pat,

Did you know that Dr. Vincent Tuohy of the Cleveland Clinic has developed a preventive breast cancer vaccine that was 100% effective in preventing breast cancer in mice.  It also effectively reduced tumors in mice that already had cancer.  The vaccine is ready for human clinical trial and Komen turned it down.

I wonder, what would happen to the Komen Foundation and the drug companies if this vaccine is as effective in women as it was in mice?

We need The Pink Vaccine funded now!