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Mammography debate continues

COPENHAGEN, DENMARK. The prestigious Cochrane Institute has issued a review of the benefits of breast cancer screening. This latest review is based on the conclusions reached by two Danish researchers, Ole Olsen and Peter Gotzsche, in a previous study published in 2000. The review concludes that there is no evidence that mass screening mammography reduces overall mortality among women ( Says Richard Horton, editor of The Lancet in commenting on the study, "At present, there is no reliable evidence from large randomized trials to support screening mammography programs."

The Danish researchers also concluded that mass screening programs are associated with a 20 per cent increase in mastectomies and a 30 per cent increase in overall surgery. The Cochrane Breast Cancer Group did not include this observation in the final review as they found it too controversial.

It would appear that the support for mass screening (mammography) for breast cancer is waning. The Cochrane review concludes, "The currently available reliable evidence does not show a survival benefit of mass screening for breast cancer (and the evidence is inconclusive for breast cancer mortality). Women, clinicians and policy makers should consider these findings carefully when they decide whether or not to attend or support screening programs." Editor's Note: The fact that mass screening for breast cancer is ineffectual does not mean that mammography cannot be a useful diagnostic tool if breast cancer is suspected.
Olsen, Ole and Gotzsche, Peter C. Cochrane review on screening for breast cancer with mammography. The Lancet, Vol. 358, October 20, 2001, pp. 1340-42 (research letter)
Horton, Richard. Screening mammography – an overview revisited. The Lancet, Vol. 358, October 20, 2001, pp. 1284-85 (commentary)
Mayor, Susan. Row over breast cancer screening shows that scientists bring "some subjectivity into their work". British Medical Journal, Vol. 323, October 27, 2001, p. 956

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