And the Mammogram Screening Discussion Goes On

In a recent essay she wrote for the New York Times, Dr. Susan Love, a breast cancer specialist speaks to women have been led to believe that screening is the best prevention.

Dr. Love writes, “The original screening study done in the 1950s on postmenopausal women in New York demonstrated a 30-percent decrease in deaths from breast cancer. It also led to the conjecture that if we just carried out more screening at a younger age, and more often, we could improve these statistics and “win the war” on breast cancer.

But decades later, the success rate of screening remains nearly the same, even with much better imaging: routine mammography screening results in a 15- to 20-percent decrease in mortality in women over age 50.

Why hasn’t the situation improved? It turns out that there are at least five, and probably more, different types of breast tumors, growing and spreading at different rates. Some are so aggressive that they have almost always spread before they are visible on mammogram. But other tumors, if left alone, may never spread at all and do not need to be found.

This more complicated picture explains why mammography has not further decreased mortality. The X-rays find some cancers at a point that makes a lifesaving difference — but not all of them.

British researchers estimated last year that one death from breast cancer is prevented for every 400 women ages 50 to 70 who have a regular screening over a 10-year period.”