Local doctor weighs in on recent study that questions the value of mammograms

American women know the drill. Get that first baseline mammogram at age 40. Since approximately one in eight women will develop invasive breast cancer, the American Cancer Society teaches that mammogram save lives.

However, a long term Canadian-based study casts doubt as to whether mammograms truly make a difference when it comes to death rates in women. This was a huge study, following 90,000 women over 25 years. The study found that death rates from breast cancer were the same whether women had mammograms or not.{} It also found that mammography can even result in unnecessary treatment.

One local doctor says she is not yet convinced by the study, but admits controversy over mammography is nothing new.

"Not everybody is going to get breast cancer. So I think that's where's the fine line of who needs mammograms and who doesn't," said Doctor April Maddux, general surgeon and oncologist at the Breast Care Center of Birmingham.

She is familiar with{} debates surrounding mammography. "I think the question still lies with where do we start. And that is still a debate in this country. Should we start at 40, should we start at 50, should we start at 30?," she said.

Though people may disagree about when to start having mammograms, Maddux says she's surprised about this Canadian study that questions the value of mammograms altogether. "At this point in time I would still say yes, screening mammograms are important. And I would still start at the age of 40. We even actually recommend a base line at 35 just so we have something to compare."

The controversial 25-year study just released found mammograms are not as instrumental in saving lives as we believe. By following 90,000 women for two and a half decades, researchers{} found annual mammographies did not reduce deaths from breast cancer. 180 women died who had received mammograms. 171 women died who had not.{}

Maddux says studies of trials conducted in the united states have proved otherwise. "In this country, the eight randomized trials that they looked at did show a reduction by 15 to 30 percent in mortality rate by screening mammograms."

The Canadian researchers claim studies that found mammograms are helpful were done prior to the use of Tamoxifen, a drug that greatly reduces the death rate. The study also found 22 percent of women were being over diagnosed with cancers that would never have been fatal. Still, many of these women underwent surgery, chemotherapy and radiation. Maddux calls that information misleading. "If you've got cancer cells beginning to form that's not really an invasive cancer. If you diagnose that in an 60 or 70 year old woman, yeah that's probably not going to kill them. But if you diagnose that in a 40 year old lady, leave that there long enough and it will take their life," she said.

Maddux, along with many other American doctors who have spoken out about the study, question the technology used. "Those mammograms that were done there are your old mammograms. They are not the high tech digital mammograms that we've been doing."

Still, the chief of cancer control for the American Cancer Society says the Canadian study will be reviewed prior to issuing revised guidelines later this year. "What they may do is say we're not going to start screening mammograms until 50 if we're on a national screening program. That, I wouldn't be surprised if they did. Not from a mortality standpoint, but from a cost standpoint alone."

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