Mammograms Still Recommended, Benefits Seen With Long-Term Outcomes

With two recent studies offering differing opinions on whether mammograms are beneficial, many may be questioning the benefits of the screening technique. However, the latest study clears up the confusion, pointing out two main reasons for the very different results and confirming why mammograms do indeed make a difference in preventing breast cancer deaths.

Mixed Messages Regarding Benefits of Mammography

The controversy started two years ago, when a Danish research team reviewed seven major European clinical trials focusing on mammography. The Danish researchers reported that five of the seven studies were inaccurate, citing that the participants were incorrectly selected and, therefore the data was unreliable. The Danish team then reviewed the two remaining studies and concluded that mammography screening was not justified.

Despite the finding, the American Cancer Society (ACS), along with other medical experts, still supported mammograms as an effective screening tool for breast cancer.

However, the controversy continued with an announcement from an advisory panel of expert physicians connected with the National Cancer Institute (NCI). The panel backed the Danish researchers' claim that there was insufficient evidence proving that mammograms prevent breast cancer deaths.

Now a new study involving a team of US researchers re-evaluating the very same studies that the Danish researchers had reviewed, disputes the medical panel’s recent findings.

Latest Study Supporting Mammograms

In the latest mammography study, researchers reanalyzed the two European clinical trials. However, this time, when reviewing the studies, the US researchers went further and tracked the participant outcomes at not only five and six years, but at seven and 11 years, as well.

Initially, the US research team’s findings were in agreement with the Danish research team. Within a five-year time period, the death rate of women who had been screened was higher than the women who had not been screened.

The two research teams also had the same findings when comparing the outcomes after six years – the death rate was equal among women who been screened with those who had not been screened.

Why the Two Studies Differ

However, the big difference between the two studies was that the US research team continued to track outcomes at seven and 11 years. When reviewing the outcome totals starting at seven years, the researchers found that there were fewer deaths among the screened women versus the women who had not been screened.

The US researchers conclude that mammograms do make a difference in preventing breast cancer deaths and are an effective breast cancer screening tool for women who are 55 years of age or older; however, a mammogram's benefits may not be apparent over a short period of time.

In addition, the US researchers noticed another difference between their study and the Danish study. The Danish study lumps deaths into one category not analyzing the death occurrence or differentiating the deaths that may have been caused by surgery or other treatment complications. The US team suggests that this lack of detailed information is another reason why results from the two studies differ. The US study is published in a recent issue of The Lancet.

Mammograms Still Recommended

Despite the two studies differing opinions, the ACS and the NCI still recommend mammograms as an effective screening tool for breast cancer.

However, the two cancer organizations have slightly different opinions regarding when to begin having mammograms, as well as how often. Talk with your physician about a mammography schedule that is appropriate for you - based on your overall health and medical history, risk factors, and personal opinion or preference.

According to the National Cancer Institute, women in their 40s and older should begin having a screening mammogram on a regular basis, every one to two years.

However, the American Cancer Society recommends that by age 40, women should have a screening mammogram every year. (A diagnostic mammogram may be required when a questionable area is found during a screening mammogram.)

Both organizations suggest that women who may be at increased risk for breast cancer should talk with their physicians about whether to begin having mammograms at an earlier age.

In addition, because of the recent debate surrounding the effectiveness of mammograms, the NCI states that it will carefully scrutinize the monitoring and evaluation of new data from clinical trials evaluating mammography.

However, the organization also emphasizes the continuing need for research focusing on improving current breast cancer screening methods as well as developing new screening tools.

Always consult your physician for more information.

What is a Mammogram?

A mammogram is an x-ray examination used to detect and diagnose diseases of the breast.

The process involves the breast being compressed so that the skin is spread apart, allowing for a lower dose of x-ray to be required. A black and white image of the breast is produced allowing a radiologist to see if there are any abnormalities inside the breast.

What is Cancer?

The body is made up of various kinds of cells, which normally divide in an orderly way to produce more cells only when they are needed. Cancer is a group of diseases - more than 100 types - that present when cells become abnormal and divide without control or order.

What is a Tumor?

When cells divide when new cells are not needed, too much tissue is formed. This mass of extra tissue, called a tumor, can be benign or malignant.

benign tumors:
are not cancerous
can usually be removed
do not come back in most cases
do not spread to other parts of the body and the cells do not invade other tissues
malignant tumors:
are cancerous
can invade and damage nearby tissues and organs
metastasize - cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system to form secondary tumors in other parts of the body

What Are the Different Types of Breast Cancer?

There are several types of breast cancer, including:

The most common type begins in the lining of the ducts and is called ductal carcinoma.

Another common type, called lobular carcinoma, occurs in the lobules.

When breast cancer metastasizes, or spreads outside the breast, cancer cells are often found in the lymph nodes under the arm. If the cancer has reached these nodes, it may mean that cancer cells have spread to other parts of the body.

Cancer that spreads is the same disease and has the same name as the original, or primary cancer. When breast cancer spreads, it is called metastatic breast cancer, even though the secondary tumor is in another organ. This may also be called "distant" disease.

Types of breast cancer, in alphabetical order, include the following:

adenocarcinoma
ductal carcinoma in situ (DCIS)
infiltrating (or invasive) ductal carcinoma (IDC)
infiltrating (or invasive) lobular carcinoma (ILC)
inflammatory breast cancer
lobular carcinoma in situ (LCIS) (also called lobular neoplasia)
medullary carcinoma
mucinous carcinoma
Paget's disease of the nipple
phyllodes tumor (also spelled phylloides)
tubular carcinoma

For more information consult your physician.