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Any practitioner who wants to give women an honest assessment of the research supporting early breast cancer detection should tell them that


* mammography causes harm as well as good. 1


* mammography increases the odds of being diagnosed with and treated for a type of breast cancer that would never have become symptomatic or life threatening. 2


* there is uncertainty as to whether mammography saves lives. 2


* women given mammograms have a higher rate of mastectomy and lumpectomy than women not given mammograms. 2


* breast self-examination has not been shown to reduce the rate of breast cancer deaths, but it does increase the rate of unnecessary biopsies. 3


* no clinical trial has compared women solely given clinical breast examination with women not given clinical breast examination; therefore, it's unknown whether this early-detection method saves lives or leads to less-drastic treatment.



As for the suggestion that every woman should undergo a risk assessment, consider this oft-quoted statistic: 70% of the women diagnosed with breast cancer have no identifiable risk factors. 4 If this is true, it indicates that researchers have a long way to go in determining who's at high risk for breast cancer.




1. Baines CJ. Mammography screening: are women really giving informed consent?J Natl Cancer Inst 2003;95(20):1508-11. [Context Link]


2. Olsen O, Gotzsche PC. Cochrane review on screening for breast cancer with mammography. Lancet 2001; 358(9290):1340-2. [Context Link]


3. Baxter N. Preventive health care, 2001 update: should women be routinely taught breast self-examination to screen for breast cancer?CMAJ 2001; 164(13):1837-46. [Context Link]


4. A resource guide to breast cancer services. New York: New York City Department of Consumer Affairs; 2002. [Context Link]