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The mammography dilemma
Date:4/1/2014

sting data suggest that we have been overestimating the benefits of mammography and underestimating the harms over the years," said co-author Lydia Pace, research fellow in women's health at Brigham and Women's. "It is really important to have informed discussions with our patients to help them understand the chances that a mammogram will benefit them as well as the possible downsides of getting a mammogram, so that they can incorporate their own values and preferences in making the right decision for themselves."

Breast cancer risk rises with age, so women in their 50s and 60s receive more benefit relative to the risk of harm. Other factors, including family history and whether and when a woman has given birth, also change a woman's risk/benefit ratio.

Keating emphasized the importance of individualizing screening recommendations based on a patient's personal profile. Overdiagnosis is a particular concern among women with limited life expectancies, either due to age or some other condition. "I have 80-year-olds in my practice with life expectancies of 15 or 20 years, and 60-year-olds who will likely only live another year or two," she said. "Those two kinds of patients need different recommendations about whether to continue screenings, and it can't be based simply on the patient's age."

The researchers said that they hope that this systematic review of the literature on the risks and rewards of mammography for patients will help physicians understand the complex data, and will encourage the development and use of tools for customizing the information they share with their patients to meet each patient's individual needs. The researchers also noted that more work needs to be done to fully understand the harms of mammography.


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Contact: David Cameron
david_cameron@hms.harvard.edu
617-432-0441
Harvard Medical School
Source:Eurekalert

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