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MAMMOGRAMS SAVE LIVES IN WOMEN WITH
FAMILY HISTORY OF BREAST CANCER
While the debate about whether or not routine screening mammograms can save lives continues in some circles, the clinical research evidence supporting mammograms as a lifesaving cancer screening exam continues to accumulate. Now, a newly published public health study, which appears in The Lancet Oncology, examines the survival benefit associated with routine screening mammograms in women who have a family history of breast cancer.
In this large multicenter prospective clinical research study, which was performed in the UK, 6,710 women between the ages of 40 and 42 were enrolled in this study, and were followed for an average of about 4 years. These women, who had at least some family history of breast cancer, underwent annual screening mammograms as part of this clinical research study. This study used two important control groups to assess the impact of regular annual screening mammograms on the risk of mortality in these young women. The first control group consisted of women who were at average risk for breast cancer (these women, themselves, served as the control group for the enormous UK Age Trial, which included more than 106,000 patient volunteers, and which recently reported a 10-year follow-up of its results). The second control group, against which these 6,710 women with an intermediate familial risk of breast cancer were compared, included young women from another large public health study that was performed in the Netherlands.
Among the 136 women who were diagnosed with breast cancer during the relatively brief course of this ongoing study, 77 percent were diagnosed by screening mammography, while 21 percent were diagnosed when they presented with a new breast lump (or with other clinical signs or symptoms of breast cancer). (Another 2 percent of patients failed to attend their scheduled screening mammograms, and subsequently developed clinical signs or symptoms of breast cancer.)
In this study (and as other studies have shown, even among women who are at average risk of developing breast cancer), breast cancers that were detected by annual screening mammograms were significantly smaller in size, and significantly less likely to be associated with the spread of cancer to the lymph nodes. In addition to these very important breast cancer prognostic factors, women who were diagnosed with breast cancer as a result of annual screening mammograms had much less aggressive appearing tumors under the microscope when compared to women who were diagnosed with breast cancer only after a lump, or other signs of breast cancer, appeared.
Based upon the findings of this newly published study, young women with even an intermediate risk of breast cancer, based upon having one or more relatives with breast cancer, were 20 percent less likely to die within 10 years when compared with a poorly screened, or unscreened, average-risk population of young women. Moreover, this survival advantage appeared to be directly related to annual screening mammograms, once all other breast cancer risk factors among these three populations of women had been considered.
For a complete discussion of the compelling scientific evidence linking routine screening mammograms with a decreased risk of death due to breast cancer, please see the extended clinical section on breast cancer in my new book, A Cancer Prevention Guide for the Human Race.
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Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author
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