( s. “But even if the risk reductio...)Mammograms Reduce Breast Cancer Deaths, But Increase Overdiagnosis,Health

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“But even if the risk reduction is 15 percent, that to me is a significant reduction in breast cancer mortality,” he said. “So then the real issue becomes the trade-off between a reduction in breast cancer mortality and the adverse events caused by having detected breast cancers that may not have gone anywhere.”

The reviewers estimated that for every 2,000 women who are invited to get mammograms for 10 years, one woman’s life will be prolonged as a result of detecting and treating a potentially lethal cancer.

However, another 10 healthy women will be transformed into cancer patients and undergo treatment needlessly.

An additional 200 will have the anxiety-inducing experience of a false positive — being told about a suspicious finding on a mammogram that further testing reveals to be noncancerous.

“Screening mammography is clearly a double-edged sword,” said Lisa Schwartz, M.D., co-director of the Veterans Administration Outcomes Group in White River Junction, Vermont. “Regular screening will save some lives but will cause even more women to be harmed through the unnecessary diagnosis and treatment of cancers that would never have affected their health, were it not for screening.”

Many of those cancers are of a type called ductal carcinoma in situ, or DCIS. DCIS is too small to be felt as a lump and is almost always detected with mammography. About one in five cancers picked up on a mammogram — 60,000 cases a year in the United States — is of this type.

In most cases, these abnormal cells, found in the milk ducts, will never invade the surrounding breast tissue. The problem is that researchers don’t know which of these cancers will progress and which ones won’t. As a result, all women who are diagnosed with DCIS are advised to have the lesions removed.

Barlow doesn’t think the fault lies with mammography.

“If we were better judges of the cancers, then there
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