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Vast Study Casts Doubts on Value of Mammograms

One of the largest and most meticulous studies of mammography ever done, involving 90,000 women and lasting a quarter century, has added powerful new doubts about the value of the screening test for women of any age.

It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms — one out of five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment like chemotherapy, surgery or radiation.

Researchers sought to determine whether there was any advantage to finding breast cancers when they were too small to feel. The answer was no, the researchers report.

But an editorial accompanying the new study said that earlier studies that found mammograms helped women were done before the routine use of drugs like tamoxifen that sharply reduced the breast cancer death rate. In addition, many studies did not use the gold-standard methods of the clinical trial, randomly assigning women to be screened or not, noted the editorial’s author, Dr. Mette Kalager, and other experts.

Dr. Kalager, an epidemiologist and screening researcher at the University of Oslo and the Harvard School of Public Health, said there was a reason its results were unlike those of earlier studies. With better treatments, like tamoxifen, it was less important to find cancers early. Also, she said, women in the Canadian studies were aware of breast cancer and its dangers, unlike women in earlier studies who were more likely to ignore lumps.

Read more about this in  the February 11th New York Times article wriiten by Gina Kolata

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