Study Questions the Value of Mammograms

A Canadian study of mammography is causing a stir among cancer experts. The research found that routine mammography in women ages 40 to 49 did not lower breast cancer death rates, according to Dr. Anthony Miller, a professor of preventive medicine at the University of Toronto and the lead investigator.

As part of the study, his team followed more than 50,000 women, ages 40-49; half received annual routine mammograms. Those who developed cancer despite annual mammograms did not have lower death rates than those with cancer who skipped mammograms. (Women who received mammograms were not more likely to die of breast cancer, as erroneously reported recently, Miller emphasizes.)

Based on the study results, as yet unpublished, what is the best advice for women ages 40-49 when it comes to mammograms?

Here are two views.

Dr. Anthony Miller, professor of preventive medicine, University of Toronto; lead investigator for the National Breast Screening Study

“Screening mammograms--exams done in the absence of abnormalities--helps in cancer detection but has not resulted in a decrease in breast cancer death rates for women ages 40-49.

“If a woman has symptoms, she should get a mammogram. You can expect a mammogram to aid in the diagnosis of breast cancer. Mammograms can help detect earlier cancers.

“But for reasons we don’t understand, mammograms do not seem to reduce the mortality (from breast cancer). Another study, conducted in Finland with 30,000 women, found a reduction in death rates in those who did breast self-exam and underwent a mammogram when they had abnormalities. People (such as experts from the American Cancer Society) have been recommending screening mammograms every two years in this (40-49) age range. (Our study found) there is no demonstrated mortality reduction.”

Joann Schellenbach, spokeswoman, American Cancer Society

“We cannot comment on a study without published results.

“(But) based on what we know now, we still advise women to have mammograms according to the current screening guidelines (for women ages 40-49, a routine mammogram every one or two years, based on input from her physician; after age 50, a mammogram every year).

“The cancers in this younger age group of 40-49 are more aggressive and grow faster. As far as mammograms themselves causing cancer, there is no evidence of this in the medical literature.”