Do Mammograms save lives? The science vs. the publics impression, the NY Times explores

The yearly Mammogram is a ritual that women have adopted because for years, they were told that it can save your life through early diagnosis and early intervention. Over the past couple of years, studies that have evaluated years of data suggest differently. According to a new NY Times article which reports on a New England Journal of Medicine study, Mammograms have not saved lives but have created a large amount of interventions that were not live saving or in many cases were totally unnecessary.

Most women when they first heard about mammograms not being the life saving tool they were educated about, had difficulty comprehending that this test does not save lives, and most had either personal stories or knew people who had been diagnosed with a Mammogram and were treated successfully.

The problem is partially that women in general are more health conscious than most men, and with a belief system that has been so engrained in this current generation that they need this to stay healthy, changing these behaviors to now merge with the science of appropriate mammogram use will be difficult to do. Many women will have the test anyway because they refuse to believe the science. This happened years ago when doctors needed to curtail the unnecessary use of antibiotics which were becoming less effective as they were over used, taking 20 years to get the public on board with their new message.

The NY Times explores this in this article. Unfortunately, the public has been taught to routinely have many medical screenings done which are now being shown to have little or no value, or lead to harmful interventions. Apparently, there is a psychological need for prevention, and the medical business model has sold this to our psychological need for protection, that it will be difficult to retrain the public on the realities of the new data.

Last week The New England Journal of Medicine published a study with the potential to change both medical practice and public consciousness about mammograms.

Published on Thanksgiving Day, the research examined more than 30 years of United States health statistics to determine, through observation, if screening mammography has reduced breast cancer deaths. The researchers found that, as expected, the introduction of mammogram screening led to an increase in the number of breast cancers detected at an early stage.

But importantly, the number of cancers diagnosed at the advanced stagewas essentially unchanged. If mammograms were really finding deadly cancers sooner (as suggested by the rise in early detection), then cases of advanced cancer should have been reduced in kind. But that didn’t happen. In other words, the researchers concluded, mammograms didn’t work.

This is a bold claim for an observational study. There are countless reasons why conclusions from such studies are commonly fraught with error. What if, for instance, the lion’s share of advanced cancers occurred among women without access to screening mammograms—a fact often not available in health statistics? Or what if mammography successfully prevented a major increase in advanced cancers, leaving the health statistics unchanged?

Hippocrates, the father of medicine, called experience “delusive.” He recognized that uncontrolled observations may lead to faulty conclusions. For centuries the flawed logic of observational data seemed to validate bloodletting, an unhelpful and often harmful therapy. But most who were bled eventually improved—no thanks to the bloodletting—an observation that led medical authorities to believe in the practice.

read more