According to Breast Cancer.org, nearly 1 in 8 U.S. women will develop a form of invasive breast cancer over her lifetime. Although breast cancer incidence rates had begun decreasing in the year 2000, it is still estimated that 255,180 new cases will be seen in 2017. Additionally, 2,470 new cases are expected to be seen in men, affecting about 1 in every 1,000.
Now, new studies from Danish researchers are drawing attention to the possibility that nearly 1 in 3 women with breast cancer were treated unnecessarily. Furthermore, the decision to move forward with treatment might actually have done more to harm than help when it came to tumors that were so slow-growing that they were effectively harmless.
The Difficulties of Breast Cancer Detection
This study brings to light some uncomfortable considerations for what is already a very tough subject for many women and their physicians. Although a large portion of the medical community tends to recommend the early detection approach, this study renews the debate over whether mammograms can lead to more harmful procedures yielding limited results.
Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society wrote an accompanying editorial on the study, although he was not involved in the original research.
“By treating all the cancers that we see, we are clearly saving some lives… But we’re also ‘curing’ some women who don’t need to be cured.”
In an opposing view, the American College of Radiology strongly supports breast cancer screenings, acknowledging that mammograms lead some women to be treated unnecessarily. Still, it’s possible that the study presents the issue of overdiagnosis as more common than may actually be the case. Critics feel that studies like this one may leave women confused about how to be screened for breast cancer.
For those women who do have a tumor revealed by mammogram, the early detection can make a huge difference in the ability to receive treatment. On the other hand, if treatments are quick to use radiation, there’s the possibility that damage to the heart or other cancers can occur as a result. Perhaps the study is trying to draw attention to the fact that women have only heard the early detection message for decades, seldom considering how moving straight to intensive treatments might not always be the best decision.
Differing Advice on a Hard Subject
Still, studies show that while mammograms don’t find every tumor, they do reduce the risk of dying from breast cancer by 25% for women ages 40 to 69 according to the Agency for Healthcare Research and Quality.
In light of similar and past research, various medical groups are now offering different advice on the usage of mammograms:
• The American College of Radiology – Recommends annual mammograms from age 40 and on.
• The U.S. Preventative Services Task Force – Recommends mammograms every other year for women over 50.
• The American Cancer Society – Now recommends annual mammograms for women ages 45-54, along with a screening each following year.
Despite researchers being able to estimate the statistical rate of overdiagnosis, doctors treating actual patients can’t always tell which breast tumors are able to be safely ignored, thus erring on the side of caution. This means surgery, radiation, and chemotherapy in many cases – treatments which aren’t exempt from their own known risks.
If nothing else, this study has reignited the debate over how early and often mammograms are useful, along with bringing attention to how difficult it can be for medicine to fully grapple with breast cancer and other forms of the disease.