Mammography is no longer needed?

Researchers from Norway and Denmark, working under the guidance of Associate Professor Henrik Stovring from Aarus University, have found that in recent years, breast cancer mortality has indeed been decreasing, but not due to mammographic screening.

As part of the study, the authors analyzed data on all Norwegian women aged 30-89 years and identified those who developed breast cancer between 1987 and 2010. After that, they compared the mortality rates before and after the introduction of the screening program, which consists of X-ray mammography every two years.

The results obtained do not indicate in favor of regular mammography. It turned out that the positive effects of screening were in the past. The first randomized trials conducted in the 1980s, the purpose of which was to study the effectiveness of screening for breast cancer, showed positive results. However, as treatment methods improved, screening gradually lost its effectiveness.

Dr. Stovring explains one of the paradoxes of screening – according to a popular but erroneous belief, if patients who have been screened "live longer" compared to those who have not been screened, then screening works. The problem is that during screening, doctors detect tumors earlier than it would have happened without screening. However, even if the screened patient lives longer "as a patient", this does not necessarily prolong his life as a whole. It is very important to take this fact into account and the results of the study demonstrate that screening does not prolong the overall life expectancy of women, which is the most important of the conclusions made by the authors.

In other words, women who have been screened live longer because all breast cancer patients live longer thanks to the advent of new drugs, in particular more effective chemotherapy. In addition, in recent years, the scheme of work with cancer patients has been improved, which means a faster response from the health care system than it was ten years ago. However, there is absolutely no reason to say that fewer women die from breast cancer due to mammographic screening.

Stovring also notes that it is not always good for a woman to detect small malignant neoplasms, up to 1 millimeter in diameter, during mammography. Such nodules often progress so slowly that without screening, women could well die a so-called natural death, having an undiagnosed cancer that has no effect on their health.

Instead, currently such women are diagnosed with a diagnosis that complicates life very much and requires large financial costs, which, in the end, often does not solve anything. The problem is that at the present stage, doctors cannot distinguish small cancerous tumors that threaten the patient's life from those that do not pose a danger.

All this relates to the issue of overdiagnosis, which is a rapidly worsening problem for all Western countries, where an overly active approach to diagnosis is practiced and screening programs on a national scale are widely conducted.

However, despite the fact that the results call into question health policy throughout the Western world, the authors note that their tasks do not include interference in the work of politicians. At the same time, they believe that due attention should be paid to this issue and the possibility of using other methods more effective than mammographic screening should be explored.

Article by Mette H. Moller et al. Effect of organized mammography screening on breast cancer mortality: A population-based cohort study in Norway published in the International Journal of Cancer.

Evgenia Ryabtseva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of Aarhus University: Breast cancer screening does not reduce mortality.