Large-scale study casts doubt on value of frequent mammograms

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by JANET ST. JAMES

WFAA

Posted on February 12, 2014 at 5:54 PM

Updated Wednesday, Feb 12 at 7:27 PM

DALLAS –– One of the largest studies ever performed on the effectiveness of mammograms is casting doubt on their value. 

According to the study published in the British Medical Journal, death rates from breast cancer were the same whether women got a mammogram or not. Canadian researchers followed 90,000 women for 25 years and found that one in five cancers discovered with mammography were not a threat to a woman’s health.

Yet the patient still received potentially dangerous treatments like chemotherapy, radiation or surgery. 

“Nobody knows what kind of cancer is going to kill someone,” said Baylor Medical Center radiologist Dr. Joe Spigel. “So, yes, every patient gets treated.” 

More than 40,000 people die from breast cancer each year. According to the American Cancer Society, mammograms reduce the risk of dying from breast cancer by 15 percent to 25 percent. 

Spigel called the study “deeply flawed.” The Canadian researchers based their research on an initial study that took place 25 years ago. Even then, Spigiel says medical professionals dismissed the study. 

“What you had in that study was you had bad equipment, that at the beginning of the study in 1980 was viewed to be totally worthless and they still used it,” he said. 

He said the study was not appropriately randomized, as well. 

“When you had someone who was sick with breast cancer or had a lump, they were preferentially placed in the branch where they got their mammograms because they wanted the patient to get mammograms,” Spigel said. 

"If you perform bad mammography with bad equipment with untrained technologists and physicians who didn't even know how to read it and don't properly randomize the study,” he continues, “The study is worthless."

The Canadian study supports a U.S. Preventative Task Force Committee recommendation that said women can cut back on mammograms. That is also a European recommendation. 

Many doctors are concerned the mixed messages will cause women to skip screenings. 

“All of this information coming out does nothing but hurt women,” Spigel said. “And it hurts women in a dramatic fashion.” 

The American Cancer Society has created an expert panel to review this study and other similar ones. Revised guidelines for mammograms should be released later this year. 

For patients like Georgia Philipp, however, the study isn’t affecting the annual mammogram. 

“I’ve had friends that skipped mammograms and then they found out that they had pretty advanced breast cancer,” the 67-year-old said. “That’s not going to be me.” 

Email jstjames@wfaa.com

 

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