Issue link: https://viewer.e-digitaledition.com/i/1129198
Study Reaffirms Screening Mammography's Centrality in NE W RESE ARCH PUSHES BACK AGAINST SUGGESTIONS THAT SCREENING MAMMOGR APHY MAY NO LONGER BE A PRIMARY FACTOR IN DECRE A SED BRE A ST CANCER MORTALIT Y. BY JENNA HAINES USING COMPREHENSIVE REGISTRIES for population, screen- ing history, breast cancer incidence and disease-specific death data for 52,438 Swedish women ages 40 to 69, the study in Cancer further substantiates the importance of screening mammography. This research continues work that began three decades ago, says László Tabár, MD, FACR (Hon), Professor Emeritus of Radiolog y at the University of Uppsala School of Medicine, Former Medical Director of the Department of Mammography at Central Hospital in Falun, Sweden, and Consultant Radiologist for numerous Comprehensive Breast Centers in the U.S. "In the early years, our focus was on evaluating the impact of invitation to mammography screening in a population-based, prospective, randomized controlled trial," Dr. Tabár says. "The comparison was between breast cancer deaths in women invited to an organized breast cancer screening program [those taking part and those not taking part combined] versus women not invited to screening. We found significantly fewer breast cancer deaths among women invited to screening, which led to the introduction of mammography screening in many countries." After this initial study, Dr. Tabár says, researchers turned more directly to the question of whether regular mammography screening reduced the risk of death from breast cancer. To answer this question, Dr. Tabár's research group focused only on women who were invited to the organized breast cancer screening program. Within that subgroup, the team continued to study the program's impact on mortality by comparing regular participants in screening with nonparticipants. They found that, when compared with women who did not undergo regular screening, women who received regular mam- mograms had a 60 percent lower risk of dying from breast cancer within 10 years after diagnosis and a 47 percent lower risk of dying from breast cancer within 20 years after diagnosis. THE SCREENING SCHISM Despite growing evidence from studies such as Dr. Tabár's that screening mammography is crucia l in saving lives, dubious claims against it endure. "The arguments against mammography have changed over the years," says Jay A. Baker, MD, FACR, FSBI, President of the Society of Breast Imaging and Professor of Radiolog y, Chief of the Division of Breast Imaging and Vice-Chair of Clinica l Affairs at Duke University School of Medicine. "Like a Hydra, every time we discredit one theory, two more seem to pop up to replace it." Dr. Ba ker points to periodic studies over the years citing concerns about "drawbacks" of screening. An early argument Reducing Breast Cancer Deaths 2 2 SPECIAL CLINICAL SECTION: RADIOLOGY