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How reliable is the evidence for screening mammography?
1Department of Radiology, The Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029-6574, USA.
Summary
Screening mammography significantly reduces breast cancer deaths in women 40 and older. Evidence from trials and screening programs confirms its life-saving benefits, despite recent flawed critiques.
Area of Science:
- Oncology
- Radiology
- Preventive Medicine
Background:
- Breast cancer mortality has decreased due to advancements in screening and treatment.
- Screening mammography is a widely adopted method for early breast cancer detection.
- Recent studies have challenged the efficacy of mammography screening, necessitating a review of evidence.
Purpose of the Study:
- To evaluate the established benefits of screening mammography in reducing breast cancer mortality.
- To address and refute the methodological flaws in recent studies questioning mammography's effectiveness.
- To reinforce the recommendation for routine mammography screening in eligible populations.
Main Methods:
- Analysis of data from randomized controlled trials on screening mammography.
- Review of large-scale service screening program outcomes.
- Critical evaluation of methodologies used in recent studies that questioned mammography benefits.
Main Results:
- Randomized trials demonstrate statistically significant reductions in breast cancer mortality for women aged 40-49 and 50+.
- Service screening programs show a 63% decrease in breast cancer deaths among screened women.
- Recent studies challenging mammography's validity were found to be critically flawed in their design and analysis.
Conclusions:
- Screening mammography offers a substantial and proven benefit in reducing breast cancer mortality.
- The evidence strongly supports current guidelines recommending mammography for women aged 40 and older.
- Critiques of mammography screening lack scientific rigor and do not invalidate its established life-saving impact.