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Mammograms Reduce Breast Cancer Deaths, But Increase Overdiagnosis

A new review of studies offers good news and bad news for women faced with the decision about whether to get regular mammograms.//

The good news is that screening mammography does reduce breast cancer mortality. The review found that women offered screening mammograms are 15 percent less likely to die of breast cancer than women who are not offered mammograms.

The bad news is that women in a screened population are 30 percent more likely to be diagnosed and treated for a cancer that, in the absence of screening, would never have posed a threat to their health.

“It is likely that screening mammography reduces breast cancer mortality, but the other side of the coin is the major harm of overdiagnosis and overtreatment,” said lead author Peter G?tzsche, M.D., director of the Nordic Cochrane Centre in Copenhagen, Denmark.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Mammograms can detect tumors that are too small to be felt as a lump, theoretically identifying cancer at its earliest and most treatable stage. In the United States, women are recommended to have regular mammograms beginning at age 40. While most European countries also recommend screening mammography, their guidelines advise that women begin screening at age 50.

To determine whether offering mammograms to women with no history or symptoms of breast cancer actually reduces breast cancer mortality, the reviewers pooled together findings from six randomized controlled trials involving half a million women. The researchers excluded a seventh trial from analysis because it was considered too biased to provide reliable data.

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