Mammogram Screening Associated With Higher Rates of Overdiagnosis of Breast Cancer
Researchers say the reduction in breast cancer mortality is based on better treatments as opposed to earlier detection.
HealthDay News -- According to a study published in the New England Journal of Medicine, mammography screening is more likely to pick up insignificant breast tumors than potentially life-threatening cancers in its early stages.
Researchers analyzed information on tumor size for US women aged 40 and up who were diagnosed with breast cancer between 1975 and 2012.
The investigators found that the rate of small-tumor detection (smaller than 2 cm) rose substantially after mammography screening became routine. However, there was a decline in large-tumor detection, but it was relatively small.
The researchers estimated that screening caught an additional 162 small breast tumors for every 100,000 women versus the pre-screening era. But only 30 of those 162 tumors would likely have grown larger, the researchers said.
"Although the rate of detection of large tumors fell after the introduction of screening mammography, the more favorable size distribution was primarily the result of the additional detection of small tumors," the authors write. "Women were more likely to have breast cancer that was overdiagnosed than to have earlier detection of a tumor that was destined to become large. The reduction in breast cancer mortality after the implementation of screening mammography was predominantly the result of improved systemic therapy."
Welch HG, et al. "Breast-Cancer Tumor Size, Overdiagnosis, And Mammography Screening Effectiveness". N Engl J Med. 2016; 375(15): 1438-1447.
Elmore JG. "Solving The Problem Of Overdiagnosis". N Engl J Med. 2016; 375(15): 1483-1486.