ALERT: Mammograms Leading to Widespread Overdiagnosis - Unnecessary Treatment -- In Older Women, NCI Study Reveals
An alarming new study reveals that mammograms in older women are doing more harm than good. Not only did mammography not increase survival, but the older the woman, the more likely she will suffer overdiagnosis and unnecessary surgery, radiation and chemotherapy. Among women aged 85 and older, an estimated 54% of breast cancer was potentially overdiagnosed as a result of breast 'preventive' breast screenings.
The new study titled, “Estimating Breast Cancer Overdiagnosis After Screening Mammography Among Older Women in the United States,” published in the Annals of Internal Medicine, indicates that the overdiagnosis and overtreatment of breast cancer in older women is far more widespread than commonly believed. Given that women undergoing annual or biannual screenings are not being properly informed of the risks, and in some cases only being told the purported benefits, it is pertinent that this information be shared far and wide.
Funded by the National Cancer Institute, and therefore a high gravitas study, the retrospective cohort of 54,635 women 70 years and older compared the cumulative incidence of breast cancer in those who had been recently screened, with those who did not.
The study looked at both breast cancer diagnoses and breast cancer related mortality for up to 15 years of follow-up. What makes this study exceptional is that the researchers included breast cancer death as an end point, and not just diagnoses, which makes it possible to determine whether mammography is actually having a net benefit on extending the lives of those who consent to undergo them.
Sadly, the overdiagnosis of breast cancer is exceedingly common. Breast cancer overdiagnosis is defined as screen-detected breast cancer that would not have caused symptoms or signs in the remaining lifetime. In many cases, those diagnosed with “breast cancer” actually have benign abnormalities, such as ductal carcinoma in situ (also known oxymoronically as "stage zero" breast cancer), which in the vast majority of cases will not cause morbidity or mortality if left undiagnosed and untreated.
By treating DCIS as equivalent to active cancer, and implementing surgery, radiation and chemotherapy, many of these overdiagnosed and overtreated women will have their lives cut short, despite being told that their treatments “saved their lives.” The psychosocial impacts of overdiagnosis and overtreatment, alone, have the potential to cause grave health impacts which may greatly reduce both the quality and the length of the lives of those affected.
Despite a National Cancer Institute commissioned expert panel concluding in 2013 that DCIS should no longer be referred to as "cancer," mammography campaigns continue to generate about 50,000 DCIS diagnoses in the U.S. alone, annually; most of which are treated aggressively. In tanden, ever since the pharmaceutical industry launched mass mammography campaigns in 1985, they continue to be marketed to the public as the most effective way to "prevent breast cancer," despite a growing body of evidence to the contrary.
The study found the following results, stratified by age:
* Among women aged 70 to 74 years, an estimated 31% of breast cancer among screened women were potentially overdiagnosed.
* Among women aged 75 to 84 years, an estimated 47% of breast cancer among screened women were potentially overdiagnosed.
* Among women aged 85 and older, an estimated 54% of breast cancer among screened women were potentially overdiagnosed.
* There were no significant reductions in breast cancer–specific death associated with screening.
As can be seen above, overdiagnosis of breast cancer in older women is happening at an alarming rate, and constitutes a significant public health threat which should be taken as seriously as the harms of polypharmacy in elderly popluations.
This latest finding speaks to how important it is for women of all ages to understand the problem of overdiagnosis, overtreatment, and having access to information not colored by the medical and pharmaceutical industries who often have agendas that bias information towards interventions that carry more risks than benefits.
In May, for instance, we reported on the U.S. Preventive Services Task Force (USPSTF)’s new draft recommendations urging all women to undergo x-ray mammography breast screenings every other year, starting at 40 instead of 50, as previous guidelines from 2016 recommended.