Study: More Breast Cancer Deaths Occurring in Younger, Unscreened Women

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Getty Images/Science Photo Library RF / Getty Images/Science Photo Library RF

The latest data questions the most recent recommendation for breast cancer screening by the U.S. Preventive Services Task Force (USPSTF), which advised women to get mammograms every other year starting at age 50.

But the new study from Harvard University researchers found that half of 600 women they studied who died of breast cancer were under age 50. The women were diagnosed between 1990 and 1999 at two Boston hospitals and followed until 2007; 71% of those who died had never had a mammogram before their diagnosis.

That suggests that mammograms may be helping to save lives, particularly among younger women, whose denser breasts may make smaller lesions more difficult to detect — and therefore require more vigilant monitoring. While the USPSTF recommendations are followed by many doctors and physician organizations, the American Cancer Society continues to advise women to get annual mammogram screenings once they reach age 40.

The USPSTF’s recommendation was based on data suggesting that widespread mammogram screening was not providing sufficient benefits in preventing cancers and saving lives when compared to the risks associated with the screenings, which include false positive results that require additional, invasive procedures such as biopsies and treatments, and overdiagnosis.

Read about the USPSTF’s decision to roll back their recommendations in 2009, here.

7 comments
galaxykid2000
galaxykid2000

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JEB52
JEB52

Women need to be so careful with screening advice and recommendations, there are powerful vested and political interests in women's cancer screening. What's best for us is their last concern - self-interest wins every time.

I look to the Nordic Cochrane Institute for unbiased information on the risks and actual benefits of screening. They were so concerned at the misleading information being given to women that they produced their own summary of the evidence for and against breast screening, you'll find it at their website. The NCI is an independent, not-for-profit, medical research group and highly regarded, especially by those I respect in the medical world. Professor Michael Baum, UK breast cancer surgeon, Dr Gilbert Welch from Dartmouth Medical School, Dr Margaret McCartney, Scottish GP and advocate for informed consent, Professor Robin Bell from Monash University and a few others.

The evidence is not good and that's why women tend to get orders, slogans and scare tactics, "Get screened, it could save your life" when we should be given the evidence and be respected enough to make our own informed decisions and that might be a NO, thank you.

I declined screening after doing my own research, I also, attended a conference on evidence based medicine this year and heard Peter Gotzsche from the NCI speak on this topic. 

About 50% of screen detected breast cancers are over-diagnosed, the fall in the death rate is mostly about better treatments, not screening (as claimed), screening results in more mastectomies, not less (as claimed) and any benefit of screening is wiped out by those who die from lung cancer and heart attacks after treatments, like radiation therapy and chemo.

Screen or don't screen, but make sure it's your decision, an informed decision.

Note: a fortune is made from screening, make sure any advice is actually in YOUR best interests. Look behind the speaker, do they rely on funding from the screening program? Do they have a commercial interest in mammography? Are they aggressively defending screening? Why? Those who really care about women respect informed consent and our right to all of the evidence...and don't just give us orders, try to scare or pressure us and if pushed, cherry-pick research that favours screening.

TrueAwareness
TrueAwareness

Mammography rests on unscientific dogmas instead of good science. Viewing this new study finding within the larger picture of mammogram research reveals its absence of scientific significance and value. Specifically, against the background that the most prominent pro-mammogram studies are heavily flawed, that studies in support of mammography tend to exaggerate the benefits of screening, that just about any study in favor of mammograms is led by scientists bogged down with vested interests (such as Kopans, co-author of this new study), and that many credible studies found no noteworthy reduction in mortality of breast cancer (read the ebook "The Mammogram Myth: The Independent Investigation Of Mammography The Medical Profession Doesn't Want You To Know About" by Rolf Hefti). And, surveys reported that if women had knowledge of the real facts about mammograms, many would stop getting them.

Scientist
Scientist

This article suggests more screening of younger women with dense breasts, but the author seems not to understand the whole issue.  For one thing, the article implied that cutting back on screenings was causing these deaths, but the women they looked at were diagnosed back in the 90's, before the recommendation even went into effect.  Now, here's what the author didn't mention, from someone who has actually researched mammography and x-ray physics:

1) Mammograms often don't WORK in young women with dense breasts.  It's tough to see tumors in the x-ray picture, and when a woman under 50 with large dense breasts gets a mammogram, often it comes back inconclusive, meaning the doctor just can't tell if there's a problem or not, because there's too much tissue in the way.  This has happened to several people I know in recent years, and they had to have follow-up sonograms or MRIs.

2) Women who develop breast cancer under 50 are inherently more likely to die of it, because the cancer moves faster and is more aggressive.  It's just a nastier disease in young women.  Women in their 50s and 60s tend to be diagnosed earlier whether they're screened or not, and generally respond well to treatment.

3) Because breast cancer moves faster in young women, even if we did annual mammograms, a lot of cancers wouldn't be detected in time.

4) Currently, about one positive mammogram in 10 is cancer, and about 70% of cancers detected on mammogram are actually dangerous.  However, breast cancer is actually extremely rare in young women, and because of that, the number of false positives will be even higher.  False positives mean additional testing and painful biopsies.

Now, none of this applies to women with a strong family history, or women who have signs or symptoms suggesting cancer.  They should be tested promptly.  But screening the entire population requires a risk-benefit analysis.

naturesplatform
naturesplatform

Instead of irradiating young women to possibly detect tumors, inform them of the real cause of breast cancer, explained at  http://www.isisboston.com/assets/PDF-Files/Bras-and-Breast-Cancer.pdf .Prevention is much more valuable than early detection. Women in Asia and Africa never got breast cancer until they adopted the perverse western custom of wearing bras. They constrict the tissues and trap the waste products of cellular metabolism. The result is inflammation and malignant mutations.

ErsieCourea
ErsieCourea

It would be good if breast cancer ends but mammograms won't do it. We have to admit that it is caused by hormone imbalance and try to rectify it by optimum nutrition, a healthier environment and nature-based healing. This should start from the cradle. Breast feeding helps mum and baby. I was a hefty 5 kilos at birth. Even that is considered a risk factor for breast cancer.