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Breast screening: Can it do more harm than good?

By Andrew John     Oct 30, 2012 in Health
Women in the United Kingdom could be having treatment for breast cancers that may never have been fatal, a review has shown.
Women are now to be given more information about the possible harm in being tested.
The UK government says the information will be included on leaflets and will enable women to make an “informed choice”.
“Screening has been a fixture in diagnosing breast cancer for more than two decades,” the BBC reports. “Women aged between 50 and 70 are invited to have a mammogram every three years. It helps doctors catch cancer early so treatment can be given when it is more likely to save lives.”
Whether breast screening does more harm than good has been the subject of “fierce debate”, says the BBC report, which cites an article in the British medical journal the Lancet.
And the government’s national cancer director, Prof. Sir Mike Richards, said it had become “an area of high controversy”.
The debate, says the BBC report, centres on “the concept of ‘overdiagnosis’, that is screening which correctly identifies a tumour, but one which would never have caused harm. It leads to women who would have lived full and healthy lives having treatments – such as surgery, hormone therapy, radiotherapy and chemotherapy – which have considerable side effects.”
The Lancet says:
The main questions are how large the benefit of screening is in terms of reduced breast cancer mortality and how substantial the harm is in terms of overdiagnosis, which is defined as cancers detected at screening that would not have otherwise become clinically apparent in the woman’s lifetime.
Screening, it says, “reduces breast cancer mortality but that some overdiagnosis occurs.”
Another potential problem with breast screen was reported in Digital Journal in September, in an article by Greta McClain.
“The use of mammograms, the traditional gold standard for detecting breast cancer in women, may actually increase a women’s risk of developing the disease,” she wrote.
Citing an ABC report, she wrote that “young women with a high family history of breast cancer may raise their risk of developing breast cancer when they are exposed to diagnostic radiation sources such as mammograms and X-rays.”
If women are carriers of a type of mutation known as BRCA1 or BRCA2 and receive any type of diagnostic radiation in the chest area before they’re 30, they’re “90 times more likely to develop breast cancer”, said McClain’s report.
Dr Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said: “This will raise questions and caution flags about how we treat women with [gene] mutations.”
More about breast screening, Breast Cancer, Mammogram, mammograph, Cancer