This article reports on the results of a study of nearly 170,000 women who had screening mammograms beginning between age 40-59. The study found that over ten years of screening mammograms, over half of the women will experience a false-positive recall for additional mammography. In addition, 7%-9% of the women will have a biopsy for a suspicious lump which is not cancerous.
Both of those percentages decrease if the woman is screened every other year rather than every year. Even with biennial mammography, 41% of women will experience a recall over 10 years of mammography. The study’s Principal Investigator emphasized that “in most cases, a recall doesn’t mean you have cancer.” She hoped this knowledge would reduce the anxiety of women who are recalled.
The story never explained the size of the decrease in the number of false positives between annual (61.3%) and biennial screening (41.6%).
Our first two reviewers were a researcher who specializes in health decisions and a breast cancer survivor trained in evidence by the Natiional Breast Cancer Coalition’s Project LEAD.
This study is valuable because it helps to quantify and compare the harms of annual and biennial screening, specifically the number of false positives and the number of unnecessary biopsies. Prior to this study, estimates of false positive screening mammography rates varied widely.
The critical question is whether you can do less frequent screening, subject women to fewer harms and get similar results in terms of detection of
“early stage” cancer. This study’s data seems to suggest that answer is yes.
While the financial costs of screening mammography & false-positive recalls & biopsies were not included in the study, readers would benefit from being reminded that recall mammography & biopsies increase patient financial costs.
This article leads with valuable information for all women over age 40 by stating “Getting screening mammograms every two years instead of annually reduces the chance of a false alarm, a new study shows.” Unfortunately the writer doesn’t quantify or elaborate adequately on that reduction. Instead, the writer later focuses on how women undergoing screening mammography shouldn’t be anxious if they experience a recall because over half of women who have screening mammograms for 10 years will be recalled.
Readers would have been better served if the writer had emphasized the significant reduction in both recall mammograms & false-positive biopsies in women who are screened every two years rather than annually. Part of the continuing controversy over screening mammography focuses on annual versus biennial screening. Because this study showed a significant reduction in the percentage of those recalled & needing biopsies among women who are screened every other year, with no statistically significant increase in late-stage diagnosis of breast cancer, the article should have emphasized those important findings.
The piece states that the researchers noted that “…false positive recalls may cause inconvenience & anxiety and biopsies can cause pain and scarring.”
This article fails to include several important facts about the study. 1) This is a prospective cohort study of women screened between 1994-2006. 2) Most of the mammograms were film rather than digital. 3) Few women underwent screening for the entire 10 year period. 4) Screening mammography recall rates are influenced by the skill of the radiologists who read the mammograms.
No independent experts were quoted.
The story did an adequate job comparing – at a very high level – annual screening versus biennial screening.
Screening mammography is widely available throughout the United States.
The study did not examine a new procedure.
There’s no evidence that the story relied solely on a news release.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like