Yearly mammograms do more harm than good

New Delhi: It has long been advised that women from the age of 45 onwards would benefit from a yearly mammogram. Breast cancer cases have steadily been increasing. Current statistics in India show that one in every 22 women develops breast cancer and the survival rate is only 50 percent.

But it has been discovered that getting annual mammograms result in more harm than good, especially on average-risk women. This concern was recently expressed by the American College of Physicians, but had been reiterated by Indian oncologists for a decade, reported The Telegraph.

New evidence suggests that women between the ages of 50 and 74 should get a mammography done once in two years rather than annually. ACP also warned that for women aged between 40 and 49, mammography can result in more harm than good. This statement, though, excludes women who have had a history of breast cancer or have a genetic mutation making them susceptible to the same.

“Harms of breast cancer include overdiagnosis, overtreatment, false positive results, radiation exposure and radiation-associated breast cancer and breast cancer deaths as well as worry and distress from tests and procedures including breast biopsies,” the ACP said.

The statement published by ACP also states that medical evidence shows that 7 per cent of women who get mammograms done annually receive a biopsy recommendation due to a false positive. On the other hand, only 4.8 percent of those who screen every other year got recommendations.

The recommendations provide “clarity and simplicity amidst the chaos of diverging guidelines”, physician-epidemiologist Joann Elmore and radiologist Christoph Lee at the University of Washington in the US wrote in a commentary in the journal.

ACP released guidelines after a rise in the number of annual mammograms in several countries including India. Although Indian gynaecologists recommend annual breast screenings after the age of 45, ACP set different guidelines after a recent study. Women between the ages of 40-44 have a choice of getting themselves screened, from 45-54, they must be done annually; and after the age of 55, women should switch to getting mammograms every two years.

Overdiagnosis, meaning diagnosing a form of cancer that will not leave the person sick or a risk to their health, has emerged as a real concern. Such cancer when detected is not of any clinical benefit to the woman. Even then, 20 percent of those diagnosed with breast cancer are said to be overdiagnosed and overtreated.

Tata Memorial Centre, Mumbai, which is India’s largest cancer hospital, has been voicing concerns about overdiagnosis for over 15 years. “The new (ACP) guidelines are exactly what we had proposed 15 years ago,” Rajendra Badwe, a senior surgical oncologist and director of TMC, told The Telegraph.