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One third of breast cancer operations unnecessary
New research indicates that national mammography screening programs have little impact on mortality but a clear influence on operations that are not strictly necessary. The findings should result in a serious debate said a professor behind the study.
A national screening program among women aged 50-69 was supposed to increase the chance of survival of breast cancer victims, but now researchers believe that some women are paying a high price for the rescue of others.
A study published in the prestigious British Medical Journal Thursday suggests that the screening process results in many women undergoing unnecessary surgery.
The study concluded that one of three cases of diagnosed breast cancer would not have resulted in illness, which works out to between 600-700 Norwegian women who were treated with surgery, possible radiation therapy and resulting psychological trauma - to treat benign tumors.
The result of screening programs has been a 50 percent rise in diagnosed breast cancer among women aged 50-69, but without any notable reduction in the occurrence of breast cancer in women over 70.
"Some of the tumors one discovers are very small and would never produce symptoms. Even if they look like cancerous tumors, and are so from a definition we pathologists use, the figures from our study show that they do not behave like cancer, but like benign tumors," said professor Jan Maehlen at the pathologic-anatomic wing of Ullevaal University Hospital, part of the team responsible for the research.
The study is based on figures from the Cancer Register in Norway and Sweden. Since the study included incidences of breast cancer from women who did not take part in screening, the real percentage of benign cases is higher.
"It means that in reality more than half of the tumors discovered during screening were of a sort that would not have led to disease," Maehlen said.
"Sweden has had screening since 1991 and should now see a clear effect in the shape of reduced mortality. This is not the case. Rather, mortality is the same as in Norway. This, together with our findings, should lead to a thorough debate about screening," Maehlen said.
Aftenposten's Norwegian reporter
Anne Hafstad
Aftenposten English Web Desk
Jonathan Tisdall
MAMMOGRAPHY
* The technique of using x-rays to examine the breast and diagnose cancer at an early stage.
* A test project of mammographies every other year for women aged 50-69 began in Oslo, Akershus, Hordaland and Rogaland in 1996.
* Norway's parliament, the Storting, has approved national screening for all women in the age group 50-69. This was established in all counties in 2003.
* Breast cancer is the most common form of cancer among women in Norway. Nearly 3,000 new cases are discovered every year, and 800 women die of the disease annually.
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