Designated as Breast Cancer Awareness Month, October is traditionally a time when breast health organizations stress the importance of early detection. In an interesting twist this October, an analysis released in last week’s Journal of the American Medical Association reveals that too much emphasis has been placed on the benefits of breast cancer screening. According to the authors, the observed increased incidence of early-stage breast cancer—without a corresponding decrease in detection of late-stage cancers—point to the potentially overstated benefits of mammograms. Based on these findings, there is concern that screening is leading to the detection and treatment of non-lethal tumors, while not aiding in the more timely diagnosis of aggressive cancers.
An article in last week’s New York Times states that the American Cancer Society (ACS) will soon release a statement in support of the journal’s findings. Yet, ACS and other cancer advocacy organizations may be hard pressed to effectively communicate this new (and nuanced) message about breast screening. The general public and people in the breast cancer community may be invested in the use of mammography (and other early detection methods) because of anecdotal experiences of their life-saving effects. Others may conflate the ineffectiveness of mammography at the population level with its lack of benefit at the individual level. Overall, individuals will now be responsible for weighing the potential risks and benefits of breast cancer screening when deciding whether to undergo mammography.
To learn more, you can follow the link to the NY Times article or access the JAMA article through the University of Minnesota Bio-Medical Library:
http://www.nytimes.com/2009/10/21/health/21cancer.html?_r=1&scp=3&sq=breast%20&st=cse
Esserman L, Shieh Y, Thompson I. Rethinking Screening for Breast Cancer and Prostate Cancer. JAMA. 2009; 302(15): 1685-1692.