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Regular Screening Mammograms Save Lives, but Cause Overdiagnoses

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A Norwegian study found that while regular screening mammograms save lives, they also cause overdiagnoses of breast cancer. Overdiagnosis means either:

  • regular screening mammograms find suspicious areas that would have eventually been diagnosed as cancer by other means, without any effect on prognosis
  • regular screening mammograms find suspicious areas that never would have affected the woman's health if they hadn't been found or treated

The study was published in the April 3, 2012 issue of Annals of Internal Medicine. Read the abstract of Overdiagnosis of Invasive Breast Cancer Due to Mammography Screening: Results From the Norwegian Screening Program.

Norway began a national breast cancer screening program in 1996. The program started in four counties and gradually expanded over the next 9 years. The entire country now participates in the program, which allows women age 50 to 69 to get a mammogram every 2 years.

The researchers wanted to know what happened to breast cancer diagnoses and prognoses as more and more women in Norway were screened.

For every 2,500 women who participated in the program:

  • 20 timely diagnoses of breast cancer were made
  • 1 death from breast cancer was prevented
  • 6 to 10 women were overdiagnosed

In the debate about the value of breast cancer screening and when screening should begin, overdiagnosis is an issue that raises some concerns. Overdiagnosis is an important issue, leading to possibly unnecessary tests and treatment, as well as the associated physical, emotional, and economic consequences. Doctors continue to work on ways to improve the quality of breast cancer screening programs and minimize the risk of overdiagnosis. More work needs to be done.

Still, the value of breast cancer screening must be weighed against the many timely diagnoses -- and lives saved -- that come from regular screening. Taken together, the evidence strongly suggests that breast cancer screening starting at age 40:

  • leads to diagnoses of breast cancer at earlier, more treatable stages
  • means better prognoses for women diagnosed -- and lives saved

Despite the evidence and current guidelines, many women age 40 to 49 don't get regular screening mammograms.

If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.

There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of regular screening mammograms:

  • If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
  • If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
  • If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.

For more information on mammograms and other tests to detect breast cancer, visit the Breast Cancer Tests: Screening, Diagnosis, and Monitoring pages.

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