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New Review Raises Doubts about Exact Benefits of Mammograms

Update Date: Apr 03, 2014 10:54 AM EDT

Mammograms are recommended for women over the age of 50 and for women at risk of developing breast cancer. Even though mammograms are preventive measures, several studies have examined the effectiveness of undergoing yearly ones. In a new and large review, researchers once again raised doubts about the necessity of annual mammograms. The researchers concluded that the benefits of mammograms for women in their 40s are often overstated.

In this study, the researcher examined 50 years of data conducted on the effectiveness of mammograms. In the past, women were recommended to get one mammogram every one to two years once they reach 40-years-old. In 2009, the U.S. Preventive Services Task Force (USPSTF) revised that recommendation so that mammograms are performed every two years after women turn 50. These changes came after more evidence suggested that mammograms could result in "overdiagnosis" for women in their 40s.

The new review concluded that even though mammograms can save lives, for women in their 40s, the benefits are very small. In this age group, mammograms were able to reduce the risk of death from breast cancer by an average of 15 percent. Even though there is a reduction in mortality risk, the researchers found that the risks of screening might actually outweigh the benefits.

The greatest risk for women in their 40s was overdiagnosis, which occurs when women get diagnosed with tumors that might never end up threatening their lives. Instead of leaving these tumors alone, the women have to go through unnecessary surgery, chemotherapy and radiation. Even though counting the number of overdiagnosis cases is difficult, the team estimated that roughly 19 percent of the cancer cases over 10 years of screening are most likely overdiagnoses.

"We have no way of knowing which patients will progress. So we have to treat everyone we diagnose," said review co-author, Dr. Nancy Keating, of Harvard Medical School and Brigham & Women's Hospital in Boston reported by Philly. "We think mammography has a benefit...but it's smaller than many people believe. And the risk of overdiagnosis, in particular, has not received a lot of attention."

Dr. Keating added, according to the Wall Street Journal, "There isn't a one-size-fits-all on mammograms. I have a lot of patients who say, 'I'm comfortable waiting.'"

The review was published in the Journal of the American Medical Association (JAMA).

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