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Breast cancer

09 April 2010

Mammograms: to screen or not to?

Debate still rages about whether women are getting the right information on the merits and risks of mammograms. So should you, or shouldn't you? Professor Apffelstaedt weighs in.

It's not hard to find a breast cancer survivor who thinks routine mammograms are a good idea. Almost any woman who had a cancerous tumour detected in her breast during a regular screening appointment would probably think the scan -- and subsequent surgery, radiotherapy or chemotherapy treatment to remove the cancer -- saved her life.

But that is not always true and an increasingly heated international debate is raging about whether women are getting the right information on the merits, and risks, of mammograms.

The fear is that over-diagnosis -- when screening picks up tumours that would never have presented a problem -- may mean many women are undergoing unnecessary radical treatment, suffering the physical and psychological impact of a breast cancer diagnosis that would otherwise not have come up.

Row erupts

While some scientists are locked in battle, slinging accusations at each other of misleading data and conflicts of interest, others say the row itself is a signal that it's time for a new and more refined approach to breast cancer screening.

"What really bothers me... is the poor women who are the subjects of this debate, who must be utterly confused and not know what the hell is going on or what to do," said Michael Baum, the doctor who introduced Britain's first breast screening programme more than 20 years ago. "To carry on regardless is no longer acceptable. I'm trying to find a way out of this mess."

Low level argument over the merits of mammograms has bubbled for some years, but a political storm blew up in the United States last year when public health officials questioned whether screening for women in their 40s actually save lives and proposed upping the regular screening age to 50.

 

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Ask the Expert

Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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