|
Breast Cancer Screening
Joann G. Elmore, Lisa M. Reisch, Mary B. Barton, William E. Barlow, Sharon Rolnick, Emily L. Harris, Lisa J. Herrinton, Ann M. Geiger, R. Kevin Beverly, Gene Hart, Onchee Yu, Sarah M. Greene, Noel S. Weiss, Suzanne W. Fletcher. Efficacy of Breast Cancer Screening in the Community According to Risk Level. Journal of the National Cancer Institute 2005; 97: 1035-1043.
ABSTRACT
Background: The efficacy of breast cancer screening in the community may differ from that suggested by the results of randomized trials, and no data have been available on efficacy among women who have different levels of breast cancer risk.
Methods: We conducted a matched case-control study among women enrolled in six health plans in Washington, Oregon, California, Massachusetts, and Minnesota. We examined the efficacy of screening by mammography and/or clinical breast examination among women in two age cohorts (40-49 years and 50-65 years) and in two breast cancer risk levels (average and increased risk). Women who died from breast cancer from January 1, 1983, through December 31, 1998, (N = 1351; case subjects) were matched to control subjects (N = 2501) on age and risk level. Increased risk was defined as a family history of breast cancer or a breast biopsy noted in the medical records before the index date (defined as date of first suspicion of breast abnormalities in case subjects, with the same date used for matched control subjects). Data on screening, risk status, and other variables were abstracted from medical records. Conditional logistic regression was used to examine the association between breast cancer mortality and receipt of screening. All statistical tests were two-sided.
Results: There were small, non-statistically significant associations between breast cancer mortality and receipt of screening during the 3 years prior to the index date for both the younger women [odds ratio (OR) = 0.92; 95% confidence interval (CI) = 0.76 to 1.13] and the older women (OR = 0.87; 95% CI = 0.68 to 1.12). The association among women at increased risk (OR = 0.74; 95% CI = 0.50 to 1.03) was stronger than that among women at average risk (OR = 0.96; 95% CI = 0.80 to 1.14), but the difference was not statistically significant (P = .17).
Conclusions: In this community-based study, screening history was not associated with breast cancer mortality. However, potential limitations of this study argue for a cautious interpretation of these findings.
http://jncicancerspectrum.oxfordjournals.org/cgi/content/abstract/jnci;97/14/1035
|
COMMENT: This study shows that breast cancer screening isn't worth the effort. In fact it shows that mammography increases the risk of breast cancer, although the increase was insignificant.
I wrote my article on screening several years ago. This confirms what I said then. In fact mammography, by putting pressure on any tumours in the breast, can actually help to spread cancer cells to other parts of the body. It is a barbarous technique. If you are worried that you are at risk of a breast tumour, carrying out a manual examination yourself is just as good, and far less harmful. An ultrasound scan is also less harmful. It might cost a bit, but it is not really expensive and it is definitely worth the expense.
Last updated 5 March 2007
|
"NH&WL may be the best non-technical book on diet ever written"
Joel Kauffman, PhD, Professor Emeritus, University of the Sciences, Philadelphia, PA
The Perfect Weight Plan: Be Slim without Dieting
– a completely new kind of video and DVD.
|
