Study: Mammograms May Lead to Unneeded Treatment

In a study recently published in the New England Journal of Medicine, researchers at the Dartmouth Medical School and the  Oregon Health & Science University found that screening mammography, “has only marginally reduced the rate at which women present with advanced cancer,” the authors write. The study results suggest that up to one-third of breast cancer cases, or 50,000 to 70,000 cases per year, do not need treatment.

The researchers state that mammography screening has doubled the number of cases of early-stage breast cancer detected each year, from 112 to 234 cases per 100,000 women. However, the researchers report that late-stage cancer has dropped just 8%.

Per the researchers, this imbalance suggests that breast cancer was overdiagnosed (meaning, tumors were detected on screening that would never have led to clinical symptoms) in 1.3 million women in the United States over the past 30 years; the authors estimate that in 2008, breast cancer was overdiagnosed in more than 70,000 women, or 31% of all breast cancers diagnosed. If screening were working, there should be one fewer patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage.

However, in an Associated Press article on the findings, the Dr. Linda Vahdat, the Director of the Breast Center Research Program and Chief of the Solid Tumor Service at Weill Cornell Medical College, said the study’s leaders made many assumptions to reach a conclusion about overdiagnosis that “may or may not be correct.”

“I don’t think it will change how we view screening mammography,” Dr. Vahdat said.

Click here to view the published research paper. Click here to view the AP article on the study results.

 

BSGI Molecular Breast Imaging Significantly Improves Breast Cancer Detection

Results from a multi-center patient registry, presented at a recent National Consortium of Breast Centers Annual Meeting, demonstrate that Breast-Specific Gamma Imaging (BSGI) also known as Molecular Breast Imaging (MBI) improves breast cancer detection when added to mammography and ultrasound in the breast clinic.

In this study, BSGI/MBI detected cancers in nearly 13% of patients who had negative or indeterminate mammograms and an unresolved diagnostic concern such as subtle changes in the mammogram, breast pain, a new breast lump, nipple discharge, etc. Another 4% of these patients had a high-risk lesion detected by BSGI/MBI. BSGI performed significantly better than ultrasound, detecting 92% of cancers compared to just 60% by ultrasound.

According to co-author Dr. Jean Weigert of Mandell and Blau MDs PC, New Britain, CT, “The primary advantage of ultrasound is that it does not use radiation, however, a negative ultrasound can still miss cancers. Our results demonstrate that in cases where mammography and ultrasound are negative or indeterminate, BSGI can still detect some cancers. The BSGI study does involve low doses of radiation, but the benefit of early cancer detection dwarfs the health risk from the radiation dose. In fact, there has never been a reported health impact from such low radiation doses and the benefit is evident in our data. Even according to the most conservative risk-models, the benefit outweighs the risk 680 to 1.”

Weill Cornell Medical Center offers BSGI/MBI.