The mammography debate rages on

At what age should women begin getting annual mammograms? Researchers disagree.

A new study, published in the journal Cancer, claims to prove that annual mammography for women in their forties reduces the death rate from breast cancer in this group by almost 30 per cent. This is sure to throw more fuel on the fire as experts hotly debate at which age women should begin a regular screening program for breast cancer—and even whether awareness and treatment were more important tools than regular mammograms.

The most recent study was authored by Dr. Stephen Duffy of the University of London, and Dr. Laszlo Tabar of the University of Uppsala School of Medicine in Sweden, well-known advocates of mammography, the New York Times reports. It followed over 600,000 women for 16 years, and found that the number of breast cancer deaths among women who didn’t receive mammograms was twice as high as those who did. “It is now time to stop confusing women with conflicting information. Mammography is a lifesaver for women in their forties,” Dr. Gail Lebovic of the American Society of Breast Disease said, commenting on the study.

Still, other research has claimed differently. Just last week, another widely reported study suggested that increased awareness and better treatment—and not necessarily mammograms—were the best way to reduce death rates from breast cancer, the most common cancer in women worldwide. (See Canadian statistics on breast cancer here.) Timely care and “the widespread use of adjuvant therapy have probably combined to make screening now less important, said Dr. Gilbert Welch of Dartmouth Medical School in an editorial accompanying the study, according to ABC News.

This follows even more conflicting advice. In January, two U.S. groups (the American College of Radiology and the Society of Breast Imaging) recommended that women begin getting regular annual mammograms at age 40, just two months or so after the U.S. Preventive Services Task Force recommended against routine mammograms at that age, causing an uproar among some health care professionals and patients alike.

Screening mammograms are meant to detect any signs of cancer tumours in apparently healthy women, but some argue they can do more harm than good, especially at a younger age. The disease is less common in younger women (the annual risk of developing it at age 40 is half what it is at 50), so they’re more likely to get false positive results, which can lead to everything from unnecessary biopsies to stress. That’s one reason medical bodies offer widely conflicting advice, as Maclean’s reported earlier this year. The Canadian Cancer Society says women aged 50 to 69 should get a mammogram every two years and those in their forties should talk to a doctor; both groups should get clinical breast exams. The American Cancer Society, meanwhile, recommends yearly mammograms beginning at 40.

Anyone could be forgiven to feeling confused. Until some sort of consensus on mammography emerges, one position almost every medical expert can agree on is that individual women should discuss the benefits of mammography with their doctors.

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