Many women who have survived breast cancer often say it was a mammogram that “saved their life,” a powerful testimonial that can encourage other women to get regular breast cancer screening tests.
However, what are the chances that the test actually saved a woman’s life? Not that great, according to a new analysis published in the Archives of Internal Medicine on Monday.
“The numbers suggest that at most, 13 percent of those diagnosed with breast cancer have been helped. That means the other 87 percent have not been helped,” Gilbert Welch of Dartmouth College, who led the study, said in a telephone interview.
“That is important when we keep hearing these stories from breast cancer survivors,” he said.
Welch said women who tell their stories about surviving breast cancer can be a powerful inducement for other women to get tested for breast cancer, and as mammogram technology has improved, the chances are even greater that doctors will find something suspicious.
However, early detection for some women may not be much of a benefit, especially if a cancer is slow growing, Welch and colleagues say. And many women may be diagnosed and treated for a cancer growing so slowly it might never have caused any symptoms or threatened their lives.
The findings add new fodder to the simmering debate over the benefits of screening healthy people for cancer. Earlier this month, the government-backed US Preventive Services Task Force recommended that healthy men not get a common blood test for prostate cancer, causing an uproar among cancer specialists who fear more men will die from prostate cancer.
And in 2009, the same group recommended that women under 40 not get a mammogram and that women 50 and older get the test only every other year, rather than yearly, causing an outcry from breast cancer advocacy groups.
However, screening tests have both benefits and risks, says Welch, who views the current debate as positive for patients who are starting to think more about the risks of screening.
An earlier study by Welch found that routine screening for prostate cancer has resulted in as many as 1 million men in the US being diagnosed with tumors who might otherwise have suffered no ill effects from them.
In the latest study, Welch and colleagues looked to see how much mammography reduces deaths from breast cancer.
They found that for 50-year-old women whose breast cancers were diagnosed by a mammogram, there was a 13 percent chance that the screening test saved her life.
The question, then, becomes how to preserve the benefit of mammogram without exposing so many women to the harms of over-diagnosis — which include being treated for cancers that might not cause harm, Welch said.
He said breast cancer screening technology has become better and better at spotting tiny cancers on the assumption that the earlier a cancer is detected, the better the chances of cancer survival.
However, Welch said as treatments for breast cancer get better, the need for very early diagnosis is less great.
“For years we’ve been looking harder and harder for cancer. I think the time has come to ask the question, ‘What if we looked a little less hard?’” Welch said.
Timothy Wilt of the Minneapolis Veterans Administration in Minneapolis, who wrote a commentary on the findings in the same journal, said the study gives doctors science-based information to share with patients, who are often influenced by anecdotes.
“Because survivor stories are often so powerful, but inaccurate, they can result in people making healthcare decisions that are not science based and may be wrong,” he said.
CONFRONTATION: The water cannon attack was the second this month on the Philippine supply boat ‘Unaizah May 4,’ after an incident on March 5 The China Coast Guard yesterday morning blocked a Philippine supply vessel and damaged it with water cannons near a reef off the Southeast Asian country, the Philippines said. The Philippine military released video of what it said was a nearly hour-long attack off the Second Thomas Shoal (Renai Shoal, 仁愛暗沙) in the contested South China Sea, where Chinese ships have unleashed water cannons and collided with Philippine vessels in similar standoffs in the past few months. The China Coast Guard and other vessels “once again harassed, blocked, deployed water cannons, and executed dangerous maneuvers” against a routine rotation and resupply mission to
GLOBAL COMBAT AIR PROGRAM: The potential purchasers would be limited to the 15 nations with which Tokyo has signed defense partnership and equipment transfer deals Japan’s Cabinet yesterday approved a plan to sell future next-generation fighter jets that it is developing with the UK and Italy to other nations, in the latest move away from the country’s post-World War II pacifist principles. The contentious decision to allow international arms sales is expected to help secure Japan’s role in the joint fighter jet project, and is part of a move to build up the Japanese arms industry and bolster its role in global security. The Cabinet also endorsed a revision to Japan’s arms equipment and technology transfer guidelines to allow coproduced lethal weapons to be sold to nations
Thousands of devotees, some in a state of trance, gathered at a Buddhist temple on the outskirts of Bangkok renowned for sacred tattoos known as Sak Yant, paying their respects to a revered monk who mastered the practice and seeking purification. The gathering at Wat Bang Phra Buddhist temple is part of a Thai Wai Khru ritual in which devotees pay homage to Luang Phor Pern, the temple’s formal abbot, who died in 2002. He had a reputation for refining and popularizing the temple’s Sak Yant tattoo style. The idea that tattoos confer magical powers has existed in many parts of Asia
ON ALERT: A Russian cruise missile crossed into Polish airspace for about 40 seconds, the Polish military said, adding that it is constantly monitoring the war to protect its airspace Ukraine’s capital, Kyiv, and the western region of Lviv early yesterday came under a “massive” Russian air attack, officials said, while a Russian cruise missile breached Polish airspace, the Polish military said. Russia and Ukraine have been engaged in a series of deadly aerial attacks, with yesterday’s strikes coming a day after the Russian military said it had seized the Ukrainian village of Ivanivske, west of Bakhmut. A militant attack on a Moscow concert hall on Friday that killed at least 133 people also became a new flash point between the two archrivals. “Explosions in the capital. Air defense is working. Do not