Do routine mammograms save lives?
Yes — but a number of experts strongly disagree with the consensus.
The Question:
I read an article suggesting routine mammograms don’t save lives and then another suggesting they do. Can experts please share their perspective on this important question.
The Metafact Expert Consensus:
Yes +81%. (30/37 answered ‘Yes’) as of July 30, 2018
Snapshot of expert answers of “Likely” or above
Prof Nancy Marshall, MD, Harvard Medical School: The key reason this question has received so much attention is that the benefit, especially for younger women, is very small, and we are increasingly aware of the risks of mammography, which include false positive mammograms, unnecessary biopsies, and over-diagnosis — where we diagnose cancers that would never become clinically evident in a woman’s lifetime in the absence of screening. However, since we can’t tell which cancers are over-diagnosed and which are not, we treat them all, subjecting some women to the harms of treatment without benefit. (see full answer)
Prof Kenneth Foster, Biomedical Engineering expert at Pennsylvania State University: A 2016 review concluded that ‘Breast cancer mortality is generally reduced with mammography screening, although estimates are not statistically significant at all ages and the magnitudes of effect are small. Advanced cancer is reduced with screening for women aged 50 years or older.’ So according to the best available evidence, mammography saves lives (more precisely reduces deaths from breast cancer), but it is certainly not a magic bullet.” (see full answer)
Prof Martin Yaffe, Breast Cancer Imaging expert, University of Toronto: There is compelling evidence regarding the benefits of screening, but women should also appreciate that it has limitations. (see full answer)
Snapshot of expert answers of “Unlikely” or below
Prof Robert Kaplan, Health Economist at Stanford University: I do not believe that mammography save lives…Averaged across all high quality studies, women randomly assigned to mammography do not live longer than those assigned to usual care. (see full answer)
Prof Tony Miller, Epidemiologist, University of Toronto: We have reached the point of negligible benefit from mammography screening for breast cancer in women at average risk. (see full answer)
Prof Tom Marshall, Public Health, University of Birmingham: If mammography screening were a drug it would probably not be granted a licence on the basis of the evidence… Many individuals have careers invested in delivering mammography screening or researching mammography screening or have strong emotional or political reasons for wanting to believe that it is effective. In such circumstances it is very difficult to challenge prevailing wisdom. (see full answer)
This fact-check and expert answers originally published at metafact.io.
