Feature | April 04, 2014

JAMA Article Breast Cancer Screening Recommendations Potentially Deadly for Many Women

ACR, SBI continue to recommend annual mammograms beginning at age 40

April 4, 2014 — The American College of Radiology (ACR) and Society of Breast Imaging (SBI) agree with statements made by Pace and Keating, in their article to be published in the Journal of the American Medical Association (JAMA), that women should discuss mammography with their doctor and breast cancer diagnosis and treatment may one day be more individualized. However, at present, breast cancer screening based primarily on risk — as discussed in the JAMA article — would miss the overwhelming majority of breast cancers present in women and result in thousands of unnecessary deaths each year.

The United States Preventive Services Task Force (USPSTF) made similar suggestions to those of this JAMA article. However, an analysis (Hendrick and Helvie), published in the American Journal of Roentgenology, using the task force’s own methodology, showed that if USPSTF breast cancer screening guidelines were followed, approximately 6,500 additional women each year in the U.S. would die from breast cancer. It is also likely that thousands more would endure more extensive and expensive treatments than if their cancers were found early by a mammogram.

To arrive at their recommendations, the JAMA article authors also placed too much emphasis on the obsolete and low lifesaving benefit of mammography claimed in outdated or discredited studies. For instance, the Canadian National Breast Screening Study (CNBSS) has been widely discredited and should not be considered alone or in a meta-analysis such as this JAMA article. The World Health Organization long ago excluded the CNBSS from its analyses of screening mammography’s impact of breast cancer mortality. In a recent interview with CNN, the American Cancer Society echoed methodological concerns about the study. Breast cancer groups, such as BreastCancer.org, have criticized this study and warned against following the author’s recommendations. A recent article published in The Oncologist shows that many other studies cited in the Pace and Keating article, and elsewhere, regarding over diagnosis and potential harms of mammography are not well as well-founded as has been reported and that their conclusions cannot simply be taken as fact.

More recent randomized control trials, particularly the largest (Hellquist et al) and longest running (Tabar et al) breast cancer screening studies in history respectively, have reconfirmed that regular mammography screening cut breast cancer deaths by roughly a third (roughly double that claimed in Pace and Keating) in all women ages 40 and over — including women ages 40–49. A study (Otto et al) published in Cancer Epidemiology, Biomarkers & Prevention shows mammography screening cuts the risk of dying from breast cancer nearly in half. A recent study published in Cancer showed that more than 70 percent of the women who died from breast cancer in their 40s at major Harvard teaching hospitals were among the 20 percent of women who were not being screened. Perhaps most importantly, according to National Cancer Institute data, since mammography screening became widespread in the mid-1980s, the U.S. breast cancer death rate, unchanged for the previous 50 years, has dropped well over 30 percent. These trial results and government reports may be most applicable to the current state of breast cancer screening.

Every major American medical organization with expertise in breast cancer care, including the American Congress of Obstetricians and Gynecologists, American Cancer Society, American College of Radiology, National Accreditation Program for Breast Centers and Society of Breast Imaging recommend that women start getting annual mammograms at age 40. The ACR and SBI continue to stand by these recommendations.

Mammography can detect cancer early when it is most treatable and can be treated less invasively — which not only save lives, but helps preserve quality of life.

For more information: www.MammographySavesLives.org

Related Content

In a demonstration on the exhibit floor of the SBI symposium, Koios software identified suspicious lesions in ultrasound images

In a demonstration on the exhibit floor of the SBI symposium, Koios software identified suspicious lesions in ultrasound images. Photo by Greg Freiherr

Feature | Artificial Intelligence | April 19, 2019 | By Greg Freiherr
Commercial efforts to develop...
Videos | Breast Imaging | April 18, 2019
In a keynote lecture at the Society of Breast Imaging (SBI)/American College of Radiology (ACR) 2019 Symposium, ...
Fatty tissue and breast density may be considered in the context of many factors that affect the occurrence and detection of breast cancer

Fatty tissue and breast density may be considered in the context of many factors that affect the occurrence and detection of breast cancer. Permission to publish provided by DenseBreast-info.org

Feature | Breast Imaging | April 18, 2019 | By Greg Freiherr
When planning a screening program to detect the early signs of breast cancer, age is a major consideration.
iCAD Appoints Stacey Stevens as President
News | Radiology Business | April 16, 2019
iCAD Inc. recently announced that Stacey Stevens has been named president. As president, Stevens will have expanded...
compressed breast during mammography.
360 Photos | 360 View Photos | April 16, 2019
A 360 view of a simulated breast compression for a...
A smart algorithm has been trained on a neural network to recognize the appearance of breast cancer in MR images

A smart algorithm has been trained on a neural network to recognize the appearance of breast cancer in MR images. The algorithm, described at the SBI/ACR Breast Imaging Symposium, used “Deep Learning,“ a form of machine learning, which is a type of artificial intelligence. Graphic courtesy of Sarah Eskreis-Winkler, M.D.

Feature | Artificial Intelligence | April 12, 2019 | By Greg Freiherr
The use of smart algorithms has the potential to make healthcare more efficient.
This image depicts ABUS images with QVCAD results

This image depicts ABUS images with QVCAD results.

Feature | Breast Imaging | April 12, 2019
Imaging Technology News spoke with Bob Foley, vice president of sales and marketing of QView Medical, Inc.,
Uterine Fibroid Embolization Safer and as Effective as Surgical Treatment
News | Interventional Radiology | April 05, 2019
Uterine fibroid embolization (UFE) effectively treats uterine fibroids with fewer post-procedure complications compared...