Mammography- more harm than good?

Since its development, mammography has been considered one of the most impressive advances in cancer screening. It is thought of as an essential tool in reducing morbidity and mortality from this highly prevalent disease.

Every woman who has undergone mammography knows the anxiety of waiting for her test results. For most people in this situation, the results are anxiety- relieving, and no further management is indicated. But for a few, the results will mean more tests, and more anxiety. Some of these women will turn out to have invasive breast cancer, and their lives will be saved because of screening. Others will undergo additional testing and it will turn out that they did not have invasive (or potentially invasive) breast cancer, because all screening carries with it the risk of false positives. When the benefits outweigh the harms, screening is justified.

This is why we are so excited to have Peter Gøtzsche- Director of the Nordic Cochrane Centre in Copenhagen and author of Mammography Screening: Truth, Lies and Controversy – speaking at EvidenceLive 2013. He has a different take on breast cancer screening, and is very concerned with the possibility that theharms of mammography outweigh its benefits. According to Gøtzsche, this is a big problem, and one that we should take very seriously in developing health services and deciding what is best for individual patients.

But not everyone supports these findings. Jack Cuzick, Professor at Barts and the London School of Medicine and a leading researcher in cancer screening (having been one of the first to show that tamoxifen reduces the risk of contralateral tumours), recently raised concerns regarding the Cochrane systematic review that supports Gøtzsche’s claims. Cuzick recently asserted that Gøtzsche’s desire to abandon screening altogether “has detracted from efforts to improve breast cancer screening” and has been detrimental to what should be the real goal: to refine and advance screening in order to reduce morbidity and mortality from breast cancer.

Here’s my question to you: What do you think about the role of mammography in modern healthcare?


-Originally posted on the EvidenceLive blog at


About Braden O'Neill

Assistant Professor, Department of Family and Community Medicine, University of Toronto
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