The controversy over breast cancer screening rages on, fueled by results from the Canadian National Breast Screening Study reported in the Sept. 3 issue of the Annals of Internal Medicine. This study showed that mammography plus self-examination and physician examination of women in their 40s did not reduce the death rate from breast cancer compared to self-examination and physician examination alone.
In February, the U.S. Preventive Services Task Force gave B level recommendations for mammographic screening every one to two years for women in their 40s, although their review in the same issue of the Annals suggests that available evidence supporting this position is only “fair.” An accompanying editorial notes that mammograms cause harm from increased rates of mastectomy and lumpectomy. On the other hand, an observational study from Florence, Italy, in the Aug. 24 issue of the British Medical Journal showed that conservative procedures increased but radical mastectomy rates decreased with the advent
of screening.
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