On Tuesday, the British Medical Journal published a study that questions the value of mammograms. One of the largest studies of mammography, the Canadian investigation involved 90,000 women and took 25 years to complete. The size and the scope of the study have caused the media to take note. However, the report does not offer any new data, but rather provides follow-up on an old trial, one that was used with many others to formulate today’s breast screening guidelines.
Regular mammography has long been an issue of debate in the medical community. While mammograms are not perfect tests, BCRF’s scientific leadership, Dr. Larry Norton, Scientific Director, and Dr. Clifford Hudis, Chair of the Scientific Advisory Board, join the large majority of the scientific community in recommending that women of average risk take current screening guidelines—including annual mammograms starting at age 40—seriously. We continue to believe it is a critical step in minimizing a woman’s chances of dying from breast cancer.
Screening, by providing early detection, not only increases survival rates but also minimizes the chances of needing a mastectomy or requiring chemotherapy. And just as importantly, annual mammograms can reduce the risk of metastasis, because it’s only when cancer spreads that it turns lethal (metastasis is the cause of 90 percent of cancer deaths).
While the Canadian study found that death rates from breast cancer and from all causes were the same in women who obtained mammograms and those who did not, many questions have been raised about the quality of the mammograms used in the study, as well as how the patients were randomized to the “mammography or not” arms of the trial. In a statement released yesterday, the American College of Radiology (ACR) says the results are “flawed and misleading.” Our scientific leadership agrees with the ACR in its concern that this report of an old trial could put millions of women at unnecessary risk by steering them away from appropriate breast screening.
While mammograms may not yet be perfect, screening continues to be important while organizations like ours invest in research to find better methods. Currently, grantees supported by BCRF are working diligently to develop better (that is, more “accurately predictive”) imagine tools to improve upon mammography. In addition, our funding is enabling discoveries that better prevent and control breast cancer. We are studying the fundamental properties of breast cancer cells and their environment, with a mind to making advances not only in early detection and prevention, but also in curative therapies to thwart metastatic disease. Our researchers are uncovering modifiable risk factors to help men and women proactively reduce their chances of cancer and investigating chemoprevention strategies to thwart the development of breast cancer. They are creating sophisticated tests to evaluate the genetic and molecular makeup of tumors to personalize and optimize treatment. And they are developing therapies that kill cancer cells by stimulating the immune system.
As we have learned in the last 20 years, breast cancer is a complex disease with myriad layers and connections to other cancers as well as other illnesses. There is no easy solution to one of the world’s biggest problems, but we shouldn’t be so quick to disregard one of the best methods we have to detect this disease. Mammography is central to current breast cancer control strategies. BCRF—and the scientific community at large—clearly has more to do, but our work also depends on the support of many. Now, more than ever, we need a public that is educated about the status of breast cancer management now and engaged with us in seeking advances for the future.
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