Relook benefits, harm of mammogram screening

Most of my friends who have had mammograms done have had to go for further tests like ultrasounds and biopsies.

I, too, was told after my first mammogram that a biopsy or another mammogram would be needed six months later.

I began to question why the incidence of further tests was so high just among my small circle of friends.

Some of them were diagnosed with ductal carcinoma in situ or DCIS (stage zero or pre-cancer) and were prescribed a series of treatments, ranging from radiotherapy to chemotherapy, and even mastectomy.

As I researched, I was alarmed to find studies done in the United States, Europe and Australia concluding that mammograms were not only ineffective in detecting cancer but, worse still, may result in radiation-induced cancer.

A paper by a team from Norway that appeared in the journal Breast Cancer Research noted:

• There was no drop in the incidence of invasive breast cancer after detection and removal of DCIS. On the contrary, incidence rates kept increasing in countries with mammography screening.

• Among 1,000 women who start screening at age 50 and are screened for 20 years, two to three will avoid dying from breast cancer, 200 women will have at least one false positive test, 30 will undergo a biopsy, three will be diagnosed with an interval cancer, and 15 will be overdiagnosed with breast cancer.

• The Swiss Medical Board concluded that the harm of mammogram screening outweighed the benefits, and recommended against mammography screening.

• The harm of screening has not been communicated to the public. With increasing evidence of overdiagnosis, this is of concern and reduces the possibility of an individual making an informed choice.

I hope professionals here in Singapore can weigh in, objectively consider such research and advise Singaporean women accordingly so they can make an informed decision rather than be subject to ignorance and fear.

Lilian Thia (Ms)

A version of this article appeared in the print edition of The Straits Times on June 15, 2018, with the headline 'Relook benefits, harm of mammogram screening'. Print Edition | Subscribe