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New Study Questions "Forty Something" Mammograms
From The Cancer Chronicles #18
©1993 by Ralph W. Moss, Ph.D.
For years, the 'cancer establishment' has urged women in their
forties to get routine mammograms. For example, the American
Cancer Society's guidelines specify at least one mammogram
every one to two years between the ages 40 to 49; and then once
per year thereafter.
The idea behind mammography is appealing. After all, a safe and
effective way of finding breast cancer early might save thousands
of lives. But is mammography really safe? Or effective for
"fortysomething" women?
From the start, there have been bitter struggles over this
strategy. Dr. John Bailar, former editor of the Journal of the
National Cancer Institute (JNCI), said in 1976, "There is a body
of information that the benefits to women under the age of fifty
may not be as great as was thought when the project was
started" (NY Times, 3/28/76). Critics also questioned whether
exposure to the radiation of mammography (small as it is) might
not cause as many tumors as it finds.
Now, almost two decades later, Bailar's concerns seem to be in
the process of being confirmed at NCI itself.
Recently, a Swedish study published by the NCI suggested some
potential danger from exposing the female breast to ionizing
radiation (JNCI, 10/20/93). Doctors at the famous Karolinska
Hospital in Stockholm studied women who received massive
doses of radiation therapy for benign breast disease between the
1920s and the 1950s. Admittedly, the doses these women received
were many, many times greater those given by correctly
calibrated mammography machines today. However, according to
NCI's Charles Land, it is prudent to assume that there still is a
small risk of some women developing radiation-induced tumors
from today's mammography.
Does this mean women should panic and avoid mammograms?
Land believes that for women over 50 or at high risk, benefits far
outweigh risks. However, for the average woman in her forties,
the study's findings, together with other evidence, seem to argue
against routine mammograms.
In addition, a second report in the JNCI by Suzanne W.
Fletcherof the American College of Physicians in Philadelphia
throws additional doubt on the value of mammograms for women
in their forties. For women age 40 to 49, they say, there appears
to be no survival benefit to obtaining routine mammograms, as
both ACS and NCI have vigorously recommended in the past. For
women aged 50 to 69, however, this panel concluded that routine
mammograms reduced the risk of dying from breast cancer. For
women in their 70s or older there was insufficient evidence to
draw conclusions. On 10/21/93, an advisory panel recommended
that NCI not longer give advice on mammography, but simply lay
out the facts and let people make their own informed decisions.
Coordinator Anne Beattie
@ 144 St. John's Place,
Brooklyn, NY 11217;
Phone 718-636-4433
Fax 718-636-0186