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Does breast cancer screening help or harm?

Consumer Reports News: December 12, 2011 10:43 AM

That question is more complicated than it seems, according to a new study in the British Medical Journal. It considered not just the potential benefits of routine breast-cancer screening, but the risks, too.

Twenty-five years ago, a landmark British analysis concluded that routine mammography saved lives and improved the quality of life for women, helping set the stage for making regular breast-cancer screening accepted practice. But that analysis focused only on the benefits of screening, not the risks, mostly false positive test results and the unnecessary surgery they can lead to.

For the new analysis, researchers looked at studies including a total of more than 100,000 women 50 and older and found that including the potential harms of routine mammography cut the benefits of screening in half. In the first 10 years of screening, in fact, the harms of screening appeared to outweigh the benefits, the researchers said.

That doesn’t mean that women shouldn’t undergo mammography. But it does mean that they should have a fuller understanding not only of the benefits of cancer screening, but also the risks, something that is too often left out of the discussion women have with their health-care providers.

An earlier study, also published in the British Medical Journal, helped clarify those risks. It suggested that for every 2,500 women screened for breast cancer, 1,000 or more might experience a false positive test result, along with the anxiety, stress, and follow-up tests and even procedures it can cause. Among those women, between 5 and 15 would undergo treatments, including mastectomies, for a disease that would never have affected them.

Bottom line: Breast cancer screening can indeed save your life. But, like any medical procedure, it can also harm. Deciding on what screenings you should get, and when you should get them, can be more complicated than it seems. Make sure you have a thorough discussion with your doctor about the benefits and risks of screening, and consider your own individual needs as a patient along with the best available evidence.

See more of our advice on breast-cancer screening and treatment.

Source:
Possible net harms of breast cancer screening: Updated modelling of Forrest report [BMJ]

Kevin McCarthy

   

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