One Third Of Breast Cancer Patients Are Over-Diagnosed
One out of three women diagnosed with breast cancer in public screening programs receive unnecessary treatment, according to a new study published in the British Medical Journal (BMJ).
This study by Scandinavian experts draws attention to the problem doctors encounter in detecting and treating breast cancer. It is aptly referred to as the “silent killer” of women because of how quickly and covertly it claims lives.
However, not all breast cancers are fatal.
There have been cases where the cancer grows so slowly that the patient is more likely to die of something else before it produces deadly symptoms. It is possible for cancer to remain dormant over the years and even shrink.
Doctors have no way of knowing whether a cancer will turn out to be fatal or completely harmless, so they err on the side of caution and treat all patients diagnosed with a tumor. Unfortunately, cancer treatments using powerful drugs, radiotherapy or surgery, can cause more health problems than the cancer.
Therefore, it is of utmost importance to know the number of patients being treated unnecessarily, considering the huge investment of having women undergo regular mammograms.
Karsten Jorgensen and Peter Gotzsche of the Nordic Cochrane Center in Copenhagen took on the tedious task of analyzing trends in breast cancer for at least seven years before and after the implementation of government-run screening programs for breast cancer in parts of Australia, Britain, Canada, Norway and Sweden.
They found that when screening programs were introduced, doctors indeed found more cases of breast cancer, but this also resulted in more women receiving treatment even if they did not need it.
"One in three breast cancers detected in a population offered organized screening is over-diagnosed," they estimated.
In an editorial also published by the BMJ, professor Gilbert Welch at the Dartmouth Institute for Health Policy and Clinical Research in Vermont said the findings raised a very important question as to whether the trade-off between deaths avoided and harm inflicted by screening programs is fair.
One study has noted that for every death avoided, two women are "over-diagnosed," and another study says the ratio is far higher with one death avoided for every 10 cases of unnecessary treatment.
Welch is urging the medical profession to make a simple statistical table to help women weigh the risks and the benefits for themselves in order to make an informed decision about whether or not to seek treatment for their breast cancer.
"Mammography is one of medicine’s ‘close calls,’ … where different people in the same situation might reasonably make different choices," Welch. "Mammography undoubtedly helps some women but hurts others”¦ no right answer exists, instead it is a personal choice.”
—
On the Net: