Breast cancer screening is often wrong

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False alarms are often used for breast cancer screening

Since 2005 women in Germany aged 50 to 69 have been entitled to free breast cancer screening every two years. Even the smallest tumors can be detected in mammography, but it is difficult to distinguish between benign and malignant changes. According to a study, 15 to 25 percent of the women examined were diagnosed with cancer, although they would very likely never have noticed the tumor.

15 to 25 percent of breast cancer diagnoses possibly false alarm The early detection test for breast cancer, the so-called mammography, is repeatedly criticized. On the one hand, tumors can be overlooked, on the other hand women must be diagnosed with cancer whose tumors would probably never have caused symptoms. As a result, these tumors are also treated with surgery, chemotherapy and many other treatment methods. For those affected, this often means painful and uncomfortable procedures without ever having an advantage. Because of these overdiagnoses, Mette Kalager and her colleagues from the renowned Harvard University criticize mammography screening. In the journal “Annals of Internal Medicine” they published their test results, which suggest that 15 to 25 percent of all breast cancer diagnoses could be false alarms.

For the study, the doctors examined 40,000 Norwegian women with breast cancer. More than 7,700 have been diagnosed with a tumor since mammography screening was introduced in Norway in 1996. In a comparison with the period before the screening program was introduced, it became clear that even more breast cancer diagnoses with end-stage tumors have been diagnosed since the start of the screening. However, it would have been expected that the preventive medical examinations would reduce the number of these serious cases if mammography had been of benefit to the women, the doctors assumed. In 1169 to 1948 of the 7,700 women, the tumor would never have made itself felt throughout life. This corresponds to 15 to 25 percent of all breast cancer diagnoses.

One in 2,500 women is saved from death by mammography screening "Mammography is probably not suitable for screening because it is difficult to distinguish between aggressive and harmless tumors," explains Kalager. "Radiologists recognize every small change. For women it’s a problem when cancer is diagnosed, but there are no symptoms or death. ”

Scientists have calculated that only one in 2,500 women would be saved from breast cancer death by mammography screening. However, six to ten of the women are overdiagnosed and operated and treated without ever benefiting from the procedures. "We have to point out the problem to women," warn cancer experts Joann Elmore and Suzanne Fletcher. "Just because it is sensitive to talk about the damage, we cannot keep the topic secret."

Germany has the highest breast cancer mortality rate in the EU A team of scientists led by Matteo Malvezzi from the University of Milan calculated the detailed cancer death rates for the six most populous countries in the European Union (EU). In doing so, they determined the highest breast cancer death rate for Germany. In the Federal Republic, 16.5 out of 100,000 women are affected. The EU average is only 14.9 out of 100,000 women, the Italian experts reported. Breast cancer mortality has dropped 7.5 percent since 2007, but the EU average was 9 percent. Although Germany is in a sad leading position in this case, the development of breast cancer is overall positive. Not only was the death rate of the elderly significantly reduced, the scientists also saw a significant reduction in breast cancer deaths among the younger women. (ag)

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Author and source information

Video: ACP Breast Cancer Screening Guidance


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