HEALTH BEHIND THE HEADLINES
and can induce cancer. With mammography the risk is miniscule but higher in younger women, which is one reason why invitations are limited to those aged 50-70 (by 2012 this will extend to those aged 47-73). The disease is considered more common with age – even though those in their 30s and 40s have battled it – with a higher rate of false negatives pre-menopause. A new screening method under
investigation, digital tomosynthesis, creates 3D pictures and reduces false negatives. However, there’s nothing yet to reduce false positives and it’s those that McPherson thinks cause harm. A recent Cochrane Review (the doctors’ evidence ‘bible’) stated, “For every 2,000 women invited for screening throughout ten years, one will have her life prolonged. Ten healthy women, will be diagnosed as breast cancer patients from screening findings and treated unnecessarily. And worryingly, more than 200 women will experience psychological distress because of false positive findings.” A false positive result, necessitating further tests before an ‘all clear’, is a
One in eight UK women develop breast cancer. 130 new cases are found daily (48,000 annually). It kills 12,000 women every year 1.79 million women attended breast screening in 2009/10, 73.2 per cent of those who were invited 14,229 women screened
concern but might be argued as an acceptable price to pay. The ‘ten healthy women treated unnecessarily’ refers to DCIS (ductal carcinoma in situ) – it accounts for 20 per cent of screen-detected cancers. DCIS is where cells inside some milk ducts have started turning cancerous but not spread. Around half of DCIS cases progress to invasive cancer – for the other 50 per cent the disease won’t spread. But no one can say which cases are ‘harmless’, so all diagnosed are advised to have surgery. Cancer Research UK is funding a study to identify genes that may cause DCIS, and which women are
Breast cancer – the facts
(2009/10) were found to have breast cancer and 80 per cent of cases were invasive 41.6 per cent of the invasive cancers were less than 15mm in size, usually too small to detect by hand 30 years ago, five-year survival was 52 per cent, now it’s reached 82 per cent
more likely to develop invasive breast cancer. As Jayant Vaidya from University College Hospital, London, explains, “Researching how some
women live a normal lifespan despite the presence of cancer is key. How do their bodies ensure that this cancer does not grow?” Would the money spent on screening be better spent on that? Could it be valuable in the search for cancer cures? Attending routine screening is still in the hands of the individual. For most of us, the opportunity to spot – and treat – this devastating disease as early as possible is not something to be passed up.
Decrease your risk of breast cancer by:
Breastfeeding Avoiding obesity (especially post-menopause) Limiting alcohol intake Sticking to a diet low in saturated fat Exercising – regular exercise can reduce the risk by a third
Daily Mail, Tuesday, July 21, 2009
GoodHealth
Changing faces: Stallone, left, Willis and Rourke as they were, and at the premiere, top
259 breast screenings ‘will save only one life’ SO DO BREAST
For years we’ve been told that regular mammograms save lives. But a new study has claimed that mass screenings have also led to countless women losing breasts unnecessarily
By Jenny Hope Medical Correspondent
‘TELL WOMEN ABOUT THE POSSIBLE HARM’
HAZEL Thornton has campaigned for years for women to have more information
about the downsides of screening. When she was called in for a routine mammo-
gram 18 years ago at the age of 57, Mrs Thorn- ton knew little about the possible harm. The X-ray revealed ‘ductal carcinoma in situ’
– a non-invasive form of cancer that doctors still do not know the best way to treat. After part of her breast was removed, she was
put on a five-year course of the hormonal drug tamoxifen but it made her fingernails fall out and has other side effects, so she stopped tak- ing it after 17 months. Mrs Thornton, of Row-
SCANS DO MORE
hedge, near Colchester, Essex, said: ‘It made me ask, why did I go for screening and why was I not given any proper information about it? ‘Despite promises from the screening service,
there is still no leaflet for women which spells out how it can do a great deal of harm.’ More than 16 years later, Mrs Thornton, 74, is
HARM THAN GOOD? Q&A
free of cancer but wants a proper analysis of the evidence behind screening. ‘This public health service creates damaged
women and may not be an effective use of resources. ‘Why look at two million people every year,
when 99 per cent of them will not have can- cer?’ she asked.
mammogram, my chances of survival would have been slashed.
It might have taken only
WHAT IS A MAMMOGRAM?
months for the cancer to have reached an incurable stage. As it is, I’ve been told my chances of survival are 95per cent.
My story is far from unique —
I have a friend who is a radiolo- gist who also decided on pre- emptive scanning and had a breast cancer discovered at a very early age. So early that she has avoided having a mastec- tomy and is being treated ith l
ANEWst d i
A MAMMOGRAMis, in effect, an X-ray of the breast tissue. During a routine screening, a woman has two X-rays, looking at the breast from two different angles. One is from above, taken of a horizontally-compressed breast, and oneis from the side, when the breast is diagonally compressed.
WHY ARE ROUTINE MAMMOGRAMS SUDDENLY SO CONTROVERSIAL?
contained in the breast — undergo mastectomy, when thebreast is removed The rest hav l
These are being reviewed and new versions should be available by the end of the year.
WHAT ARE THE RISKS IF I DON’T HAVE ROUTINE SCREENING?
THE WORRYis that women who have potentially lethal early-stage breast cancer could slip through the net. ‘Yes, screeningmay ca
in a differ they can ki ant to othe Ted Bian
Trust, wh research, tant step against an If the d
early pro on the m
The Ligh in Y
Page 37
Picture: ALAMY
Breast cancer screening has
little impact, say scientists
‘Attend your appointments’
By Jenny Hope Medical Correspondent
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