Breast cancer: mammograms for early detection?
Some 5,700 women are diagnosed with breast cancer every year in Switzerland. Mammograms are one method of early detection, but is this X-ray examination a helpful option? We provide the information so you can make up your mind.
Mammograms provide no indication as to whether any abnormalities found are actually dangerous tumours or ones that are growing very slowly or not at all and, as such, would never have been identified without examination. This can lead to uncertainty, and in the worst case to unnecessary treatment, making mammograms a controversial topic.
The Harding Center for Risk Literacy at the University of Potsdam has summarised the potential benefits and adverse effects of the early detection of breast cancer through mammograms based on the available scientific studies.
The medical evidence
The long-term studies looked at groups of women over 50 years of age who did or did not participate in regular mammogram screening. After ten years or more, the participants and non-participants were compared.
Effect on mortality rate
In each group, 21 out of 1,000 women died from cancer. In the group that underwent mammogram screening, 4 out of 1,000 women died from breast cancer. In the group that did not undergo mammogram screening, this figure was 5. Of the 1,000 women who participated in the mammogram screening, one was successfully treated for and survived breast cancer.
Uncertainties and overdiagnosis
Within the ten years, around 100 of the 1,000 women who participated in the mammogram screening had at least one suspicious result that only later proved not to be breast cancer. Some of these women had to live with uncertainty for many months and undergo further diagnostic tests until they could be confirmed to be healthy. In addition, 5 out of the 1,000 women were diagnosed with non-progressive breast cancer that was usually then treated with breast surgery, even though the cancer would probably not have caused any problems during their lifetime.
Mammogram screening may reduce the number of women who die from breast cancer but this has no effect on overall cancer deaths. Among all women taking part in the screening, some will be overdiagnosed with non-progressive cancer and unnecessarily treated. In light of these facts, each woman must ultimately decide for herself whether or not a mammogram is a sensible option. We hope that you now have an overview of this complex issue.
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