Controversy and Screening Mammography

Currently the AmericanCancer Society, the American College of Radiology and Society of Breast Imaging recommend that women age 40 and over should have annual screening mammography and should continue as long as they stay in good health.  While several international societies such as the Hellenic Society of Breast Imaging follow the above mentioned recommendations, the U.S. Preventive Services Task Force in their circular issued in November and updated in December 2009 recommends screening mammography every two years starting at age 50 to 74.  

In a follow up article, the British Medical Journal published 34 commentaries regarding the study “Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomized screening trial” by Miller AB, Wall C, Baines CJ, To T and Narod SA published on February 11, 2014.  Their study that was summarized in my previous post concluded that annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available.  They also found an over-diagnosis of 22%.

As the Canadian National Breast Screening study is a prospective and randomized trial, it will influence medical and lay thinking, it is therefore important its findings and all 34 thoughtful comments and rebuttals should be studied carefully before practitioners and specialists alike formulate an opinion and deviate from the current recommendations by medical societies with expertise in breast cancer.