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Breast cancer

06 March 2019

Mammograms helped save up to 600 000 US lives since 1989

The most important aspect of mammography and screening is finding and treating breast cancer early enough to save women's lives.

Widespread mammography screening and big advances in breast cancer treatment have saved hundreds of thousands of American women's lives since 1989, a new study estimates.

Researchers tracked 1990 – 2015 US data on breast cancer deaths, along with general data, on women aged 40 to 84. They found the number of breast cancer deaths prevented during that time ranged anywhere from 305 000 to more than 483 000, depending on different approaches to interpreting the data.

Media attention on risks of mammograms

They then extrapolated those results out to 2018, and calculated the number of breast cancer deaths prevented since 1989 at anywhere from 384 000 to 614 500.

In 2018 alone, between 27 000 to almost 46 000 breast cancer deaths were prevented, the investigators said.

The findings should help reassure women who wonder about the value of mammograms, said study author R. Edward Hendrick, of the University of Colorado's School of Medicine in Denver.

Recent studies "have focused media attention on some of the risks of mammography screening, such as call-backs for additional imaging and breast biopsies," he said. But those reports have also often neglected "the most important aspect of screening – that finding and treating breast cancer early saves women's lives," Hendrick said.

Mammography screening first became widely available in the mid-1980s. The new study estimates that regular screening plus improved treatments cut the expected rate of breast cancer death in 2018 by between 45 to 58%, according to the study published recently in the journal Cancer.

Important advances

"Our study provides evidence of just how effective the combination of early detection and modern breast cancer treatment has been in averting breast cancer deaths," Hendrick said in a journal news release.

One breast cancer physician applauded the new research.

"We have new immune therapies and improved surgical techniques that are important advances against breast cancer," said Dr Alice Police, who directs breast surgery at the Northwell Health Cancer Institute in Sleepy Hollow, New York.

"However, the biggest factor in literally centuries to lower the mortality rate from this devastating and extremely common disease is the humble screening mammogram," she said. "Nothing else in detection or treatment has even come close."

But Hendrick noted that only about half of US women older than 40 get regular mammograms.

Further evidence

"The best possible long-term effect of our findings would be to help women recognise that early detection and modern, personalised breast cancer treatment saves lives, and to encourage more women to get screened annually starting at age 40," Hendrick said.

Dr Kristin Byrne is chief of breast imaging at Lenox Hill Hospital in New York City. She agreed that, in keeping with guidelines from the American Cancer Society, women aged 40 and over should consider getting regular mammograms.

Byrne said the new study "is further evidence that early detection and improved treatment saves lives".

"Over 335 000 women were diagnosed with new breast cancer in the United States in 2018," she noted, and "eight out of ten of these women have no family history of breast cancer. "

According to current American Cancer Society guidelines, "women ages 40–44 should have the choice to start annual breast cancer screening with mammograms [X-rays of the breast] if they wish to do so. Women age 45–54 should get mammograms every year. Women 55 and older should switch to mammograms every two years, or can continue yearly screening."

Image credit: iStock

 

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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