Mammography Benefits? MedlinePlus.gov

NLM Director's Comments Transcript: Mammography Benefits? 11/08/2010
Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

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I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National of Medicine.

Here is what's new this week in MedlinePlus.


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Improved treatment more than mammogram screenings helped reduce breast cancer death rates among Norwegian women, finds a study recently published in The New England Journal of Medicine.
[Effect of Screening Mammography on Breast-Cancer Mortality in Norway — NEJM: Effect of Screening Mammography on Breast-Cancer Mortality in Norway — NEJM]

Four Scandinavian-based researchers originally sought to compare the impact of offering periodic mammogram screenings plus multidimensional cancer treatments with some participants who did not receive either intervention. The study's 40,000 participants (women under care within the Norwegian national health care system) ranged from age 50 to 69 and received a diagnosis of breast cancer from 1986-2005.

Indeed, the study found the combination of improved treatment plus mammogram screenings reduced breast cancer death rates about 10 percent – compared to participants who did not receive either intervention. In the study, researchers operationally defined improved treatment as receiving care from a multidisciplinary medical team instituted to treat breast cancer.

The mammogram screenings in the study followed recommended clinical protocols – and each mammogram was read independently by two radiologists.

However, in further assessing the relative contribution of improved treatments and mammograms to reduce death rates, the researchers found the death rate from breast cancer also fell by eight percent among some women in the study who received improved treatment, but did not have accompanying mammograms. Overall, the study's authors explain this finding suggests the estimated reduction in breast cancer deaths contributed by mammograms may have been about two percent.

In an accompanying editorial, H. Gilbert Welch, M.D., Dartmouth Medical School, writes the Norwegian study's findings suggest mammograms may have a surprisingly small impact on breast cancer's most important clinical outcome. Welch told the New York Times the study suggests the impact of mammograms on reducing the death rate from breast cancer is surprisingly modest. He said (and we quote): 'all the signals here are that (the impact of mammogram screenings) is much smaller than we believed' (end of quote).

Similarly, the Norwegian study's authors write they expected the benefits of a mammogram (or the magnitude of the benefit of screening) would be more significant than their findings suggest. In an article published the day following the release of the findings, the study's lead author told the New York Timesthe Norwegian researchers were surprised by the comparatively low contribution of mammogram screenings to reduce breast cancer death rates.

Conversely, the researchers acknowledged the study does not provide a statistically robust comparison of the impact of mammogram screenings on breast cancer death rates partially because participants were not randomly assigned to obtain mammograms.

Some clinical experts cited in the New York Times(following the release of the study's findings) emphasized the results should not deter public and clinical health agencies from encouraging women after age 40 to obtain mammograms at the recommended interval of every two years. While Welch's editorial agrees, he adds it may be time to reconsider if mammograms are (and we quote) 'an indicator of the quality of our health care system' (end of quote).

MedlinePlus.gov's mammography health topic page explains a mammogram is a special type of breast x-ray. Mammograms can detect tumors before they are found in a breast self-exam.

MedlinePlus.gov's breast cancer health topic page explains about one in eight American women have breast cancer. Breast cancer is the second leading cause of cancer-related deaths (following lung cancer) among American women.

Breast cancer's symptoms include a lump in the breast, a change in size or shape of the breast, or a discharge from a nipple. MedlinePlus.gov's breast cancer health topic page explains the intent of breast self-exams and mammography is to help find breast cancer early when it is most treatable.

MedlinePlus.gov's mammography health topic page provides basic information about the test in the 'overviews' section. This includes an interactive tutorial plus helpful, background websites from the National Cancer Institute and the National Women's Health Information Center.

Some of the helpful topics covered in the 'related issues' section of MedlinePlus.gov's mammography health topic page include: understanding breast changes, plus questions to ask during imaging examinations for breast cancer.

MedlinePlus.gov's breast cancer health topic page also has sections devoted to: diagnosis/symptoms, treatment, prevention/screening, coping, and disease management.

The latest research summaries and journal articles about mammography are available in the 'research' and 'journal articles' sections respectively within MedlinePlus.gov's mammography health topic page. Information about possible mammography clinical trials, which may be occurring in your area, is located in the 'clinical trials' section.

To find MedlinePlus.gov's mammography health topic page, type 'mammography' in the search box on MedlinePlus.gov's home page. Then, click on 'mammography (National Library of Medicine).'

In addition to breast cancer, MedlinePlus.gov has a comprehensive health topic page devoted to breast diseases.

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Mammography Benefits?