All women want to learn how to prevent breast cancer. For far too many, this equates to mammography, since this helps with early detection. Is this good enough?
Before we go any further, I need to make one thing very, very, very clear. Mammography is NOT prevention. I cannot tell you how many times I have been given this answer while volunteering at the Komen 3-day when I ask walkers what they are doing to prevent breast cancer. If women participating in a massive event like the 3-day do not understand the term prevention, we can assume the rest of the country has some learning to do as well.
All screening procedures do that: they screen for cancer or precancerous lesions. It is an attempt to find things before they get to the later, more difficult to treat stages. This sounds like a great idea. Or, at least it would, were it not for 2 very major problems.
First, as a society, we have a tendency to forgo true prevention in lieu of early detection. The walkers at the 3-day I have come across are evidence of this. An event this large, with this much exposure, and no one seems to understand that you really can prevent breast cancer. This is, of course, despite hundreds and hundreds (if not thousands and thousands) of research studies suggesting otherwise. On the flip side, every 3-day walker knows that it takes mammography to find that tumor early.
Second, what if there are significant harms in early detection? We all bask in the false knowledge that there is no such thing as bad screening and early detection of everything. This is certainly not the first time I’ve talked about the problems associated with overdiagnosis of breast cancers due to mammography (one previous blog post can be read here).
This particular study takes another hard look at what mammography is costing our society. Here are a few of the findings:
- The introduction of screening mammography in the US doubled the number of cases of early-stage breast cancer that are detected each year.
- However, the rate at which women present with late-stage cancer has decreased by only 8%.
- Overall, out of 100,000 women, mammography led to 122 women being diagnosed with early stage breast cancer. Only 8 of these will progress to advanced cancer (Tweet this).
With some number crunching, the authors estimated that, in the past 30 years, 1.3 MILLION women were diagnosed with breast cancer that would not have progressed. In 2008 only, this number was 70,000 women (31% of all breast cancers diagnosed).
And we all know what happens to any women who is diagnosed with breast cancer: additional testing, biopsies and potential subsequent treatment with surgery, radiation, chemo or some combination thereof.
Of course, one side of the argument would be that we just don’t know which of these 8/100,000 women are going to progress to advanced cancers. This is certainly valid. But how much more money would we be able to throw at research to answer this question if we weren’t wasting billions more on treatments that aren’t needed?