Today, New England Journal of Medicine published data showing mammography screening catches more cancers early and reduces the number of women with cancers of advanced size. Smaller cancers result in better outcomes for women, which not only helps save lives, but also allows more women to have their cancers treated with less extensive surgery, fewer mastectomies, and less frequent or aggressive chemotherapy.
According to the Society of Breast Imaging (SBI), the Welch et al. data do not support the authors’ conclusion that improved therapy is more key to breast cancer survival than mammography screening. Nor does the data support that mammography use leads to rampant overdiagnosis. The National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database used by the authors does not provide the detailed information needed to support such claims. The baseline assumption on which the conclusions are based is contradicted by the primary author’s previous papers and well-established research.
SBI also points out this Welch et al. paper reiterated the SEER database finding that there has been a 30 percent decrease in large tumors found in American women after screening became widespread. This major decline in large tumors is related to the documented increase in the detection of small invasive cancers. Not surprisingly, the same SEER database shows since mammography screening proliferated in the mid-1980s, the U.S. breast cancer death rate, unchanged for the previous 50 years, has dropped nearly 37 percent. This is in keeping with large studies (Otto et al. and Coldman et al.) that have shown that in women who get regular mammograms, the risk of dying from breast cancer is cut nearly in half.
Despite differing guidelines by the American Cancer Society, we at Garrison Women’s Health along with the United States Preventive Services Task Force (USPSTF), National Comprehensive Cancer Network(NCCN), the American College of Radiology (ACR), SBI, agree the most lives are saved by annual screening beginning at age 40.
To schedule your mammography, please call our office at (603) 742-0101.