What women’s Health And The Mammogram Controversy

Despite calls from national health organizations for women to have an annual or double mammogram every 40 years, uncertainty and controversy over the procedure continue. Based on ample evidence, mammography tests have become standard health care in many lands. However, the significance of the procedure was challenged by two Danish researchers who reviewed large clinical trials for mammography and declared that five out of seven trials were flawed and that there was no evidence that it saved lives. The report, first published in The Lancet in January 2000, was compiled by Peter Gotzsche and Ole Olsen of the Nordic Cochrane Center in Copenhagen. It found that most of the seven revised studies were negative, in part because they failed to assign women to the tested and untested groups. Two studies that have randomly assigned women, researchers say, do not show the importance of mammography. Cancer experts around the world have strongly criticized the report. Even the research institute distanced itself from the report, saying that the findings had not yet been submitted to a rigorous review of the Nordic Cochrane Center. Following a whirlwind of criticism, Danish authors reexamined their original data and declared that it “confirmed and confirmed” their conclusions, stating that “testing mammography is wrong because there is no reliable evidence that it reduces mortality.” Many women now wonder if they should continue with the annual mammogram test. For many years women have been told to get their breasts checked, but recently that advice was cut short after a major study found that it did not really work to reduce mortality due to breast cancer. However, some experts have challenged the iconoclastic report and argued that mammography saves lives. The American Cancer Society has found no reason to change its recommendation for annual mammographic screening of women over 40 years of age. The National Cancer Institute has found that screening tests have contributed to a significant reduction in mortality from breast cancer. The study, published in the New England Journal of Medicine, concludes that 28 to 65 percent of breast cancer deaths from 1990 to 2000 were due to mammogram tests. The rest was due to the powerful new drugs to treat breast cancer. In this era as mammography is widely used, the size of the tumors at the time of detection has decreased and the mortality rate of breast cancer. In the early 1980's, when only 13 percent of women in the United States received a mammogram test, the average size of a tumor was about an inch [3 cm]. By the late 1990's, 60 percent of women were regularly screened, and the average size of the tumor had dropped to about two inches [2 cm], according to the Cancer Society and the National Center for Health Statistics. This seemingly small difference in plant size is statistically significant. On average, the larger the tumor, the longer (or sooner) it grows, and the subsequent correlation between tumor size and metastasis. Strong, debilitating treatment should be done against large tumors, and even with this, the chances of survival for women with large tumors are much worse than for women with small tumors. Of course, there is always something different, and some small plants are aggressive and spread out early, while other large plants grow slowly and remain in place. At present, it is not possible to distinguish between them by mammography. Even after biopsy and microscopic examination, it is difficult to predict how the tumor will grow. There have been claims that the recent decline in breast cancer deaths, about 2 percent a year since 1990, is due to improved drugs and treatment. However, there is evidence that early detection has had a major impact. A 29-year follow-up of breast cancer deaths in two Swedish states published in 2001 revealed a 63 percent reduction in breast cancer deaths in women undergoing mammography, and no drop in the rate of untreated maternal mortality, though. the same advanced therapies were available to all. Currently, all major US medical organizations recommend screening mammography for women aged 40 and over, saying that the procedure reduces breast cancer mortality by 20 to 35 percent for women aged 50 to 59 and gradually for women aged 40 to 49 at 14 years follow-up. Mammography is an incomplete diagnostic tool. Sometimes it produces negative side effects: for women under the age of 50, mammography may miss 20 to 25 percent of existing cancers, and for women over the age of 50, miss 8 to 10 percent. For this reason, when a woman or her doctor detects a malignant lump in the mammogram, it should be evaluated in other ways, such as a biopsy.