Here's the IMPORTANT messages from this New England Journal Article (November 22, 2012).
- "We estimate that breast cancer was overdiagnosed (i.e., tumors were detected on screening that would never have let to clinical symptoms) in 1.3 million U.S. women in the past 30 years.
- "Our analysis suggests that whatever the mortality benefit, breast-cancer screening [mammograms] involved a substantial harm of excess detection of additional early-stage cancers. This imbalance indicates a considerable amount of overdiagnosis"
- "there was a larger relative reduction in mortality among women who were not exposed to screening mammography than among those who were exposed."
- "...decreasing mortality--must largely be the result of improved treatment, not screening.
- "Our finding of substantial overdiagnosis of breast cancer... replicates the finding of investigators in other countries."
- "Overdiagnosis can never be observed and thus can only be inferred from that which is observed--reported incidence."
- "...although no one can say with certainty which women have cancers that are overdiagnosed, there is certainty about what happens to them: they undergo surger, radiation therapy, hormonal therapy for 5 years or more, chemotherapy, or (usually) a combination of these treatment for abnormalities that otherwise would not have caused illness. Proponents of screening should provide women with data...
- "Women should recognize that our study does not answer the qustion 'Should I be screened for breast cancer?' However, they can rest assured that the question has more than one right answer."
- This last statement is HUGE. Author finally admitting that mammograms may be harmful and not needed for some women.