Study casts doubt on value of mammograms

A woman waits outside the mammogram and women's health services area on the first day of the fourth annual free health clinic at the Los Angeles Sports Arena in downtown Los Angeles September 27, 2012. 

When it comes to women's health, routine mammograms are part of the gospel. But now, an in depth study in the British Medical Journal says the screening tests may not be that useful after all.

Researchers followed 90,000 women for 25 years, and determined that there was no difference in breast cancer deaths between women who got mammograms and those who did not. 

Around 37 million mammograms are performed every year in the US, and they cost about $100 a piece. That’s not always money well spent, says Dr. Steven Narod, one of the study' authors.

"Our conclusion is that if it worked, we would see it," says Narod.

He adds this study is just the latest of many that have found mammograms to be ineffectual for most women. Still, mammograms remain one of the most widely used medical screenings. Nearly 75 percent of women over 40 have had one in the past year, and study findings have been widely disputed.

"The pushback comes from two sides: One is the radiologists, and secondly, the patients themselves," says Narod.

J.B. Silvers is a professor of health care finance at Case Western Reserve University. He says years of awareness campaigns and marketing have patients demanding the tests, and a lot of doctors prescribing them.

"The whole idea of medicine is 'do no harm', it doesn’t say 'do cost effective'. So, if it looks like something might be of value and might be able to help you out, there’s a big incentive to go ahead and do it."

But there can be real harm in taking unneeded tests. "We end up with 1 screen-detected cancer in 3 being over-diagnosed, and that means that women got breast cancer therapy that they really didn’t need," says epidemiologist Cornelia Baines, who co-authored the study.

In a statement, The American College of Radiology said mammograms have saved millions of lives, the study is deeply flawed, and didn’t include the most updated screening technology.

About the author

Stacey Vanek Smith is a senior reporter for Marketplace, where she covers banking, consumer finance, housing and advertising.
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I myself do not get mammograms because there is no history of cancer on either side of my family (other than lung cancer in chain smokers.) I feel my risk is so low that I'm at a greater risk of being one of those over-detected ones, and prefer to take my chances.

HOWEVER - I do want to point out a discrepancy between your report and the study's conclusions. You quote Dr. Baines as saying "1 in 3 is overdiagnosed" yet the conclusion of the study says "22% were overdiagnosed."

Isn't that 1 in 4? Either way - no mammograms for me.

I'm a breast cancer survivor. My cancer would NOT have been detected by a physical exam - it was found by mammogram and saved me from dealing with cancer that had spread outside of the duct it was found in - potentially spreading to my lymph nodes and further. If I hadn't been given mammograms since the age of 34 (10 years prior to my mother's age when she was diagnosed), I wouldn't have had a baseline at 40, and my cancer might have gone undetected. What do they want?? Tumors to grow large enough to be felt by hand before they start treating breast cancer??? I'm deeply disturbed by this study. My mother didn't receive the benefits of mammograms, and she lost her breast to cancer at 44. I DID receive mammograms, and underwent surgery and radiation, but was able to keep my breast.

@ CynthiaM
Every time they do one of these studies I hear someone say during the analysis that people who have a greater risk of the condition in question will be receiving more benefit from the procedure, so with your mother's history, you would automatically fall into the category of being advised to go ahead and screen. However, for someone who has no family history of breast cancer and no other indications that they are at elevated risk, the study is suggesting that frequent screenings are unnecessary, expensive, and in some cases even ill-advised.

Also, congratulations on your survival.

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