Breast cancer expert puts new mammogram findings into proper context

February 13, 2014 | by Tami Dennis

Yet another study is casting doubt about the value of mammograms, eroding the confidence of many women in the value of what has proven to be a lifesaving screening for breast cancer.

breast cancer Mammograms don't actually save lives, a controversial new study contends. City of Hope's Laura Kruper, however, offers some need-to-know context to those findings.

The study, published Feb. 11 in the British Medical Journal, found that death rates over 25 years were the same among women ages 40 to 59 regardless of whether or not they underwent regular mammograms.

The researchers wrote in their conclusion: “Our results support the views of some commentators that the rationale for screening by mammography should be urgently reassessed by policy makers.”

But many physicians who feel responsible for women’s health are unconvinced.

“This study does not change my view,” said Laura Kruper, M.D., head of breast surgery service at City of Hope and director of the Rita Cooper Finkel and J. William Finkel Women’s Health Center.

“Eighty percent of breast cancers are spontaneous, so there's really no way to determine who is at risk and should be getting regular mammograms,” she said. “The American Cancer Society has already issued a statement (in response to this study) that they still recommend annual screening starting at age 40.”

Like the American Cancer Society, Kruper pointed to what she considers shortcomings of the study.

“The study only looked at mortality rates, and the problem with that is that our treatments are so good now that a woman presenting with later-stage disease might do as well as a woman who has earlier-stage breast cancer because of the better treatments.”

She added: “The study does not look at morbidity. With breast cancer caught at earlier stages, there is often less-aggressive surgery, perhaps no chemotherapy ... That really matters, since chemo can have lifelong effects on people.”

Otis Brawley, M.D., MPH, chief medical officer of the American Cancer Society, said the Canadian study is just one more piece of information about breast cancer screening. His organization is certainly not changing its breast cancer screening recommendations based on it.

Those recommendations are that women age 40 and older undergo a mammogram and a breast exam every year.

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