Too Many Breast Cancer Tests?

Oct. 21, 2003 — Superfluous mammogram testing and too many breast cancer biopsies are being worn out the U.S. – causing women superfluous worry, agreeing to a controversial modern consider.

“Our think about appears that within the U.S., there are twice as many demonstrative strategies, and two to three times as many surgical biopsies in the U.S. as in the U.K … however the cancer rates were nearly identical,” says analyst Rebecca Smith-Bindman, MD, a radiologist with the College of California-San Francisco.

U.S. vs. U.K.

In her ponder, Smith-Bindman compares a host of mammogram testing insights in the U.S. and the U.K. — including nearly six million mammograms performed over a three-year period, the biggest think about thus far of the issue.

The ponder shows up in the current Journal of the American Restorative Association.

The findings:

American ladies got called back twice as often for rehash mammogram testing, compared to British women. American women were two times as likely to induce a more invasive surgical biopsy as opposed to a biopsy involving a needle to extract breast tissue for investigation. Normal comes about from biopsies (appearing no cancer) were twice as tall in the U.S. Numbers of cancers identified were very similar in the U.K. and the U.S.

“We have known that the review rate was higher in the U.S., but … we found it comes with no advantage, that it does not bring more cancers identified,” Smith-Bindman tells WebMD.

The taken a toll of so numerous strategies is one issue. “But the more substantial fetched is the emotional costs and women’s willingness to come back for screening mammography,” she says. “When they have been put through the uneasiness and surgery, to find they have no cancer, she’s less willing to come back.”

Clearly, fear of misbehavior could be a figure — although a recent consider found more fear than real lawsuits, she includes.

She would like to see more “double reading” of mammogram movies, a common practice in the U.K. It means that two radiologists in the same center examined the same film, basically giving a second opinion on the results.

A few prove appears that twofold reading “raises discovery rates and decreases recall rates,” she composes.


Otis Brawley, MD, relate chief of the Winship Cancer Established at Emory University School of Pharmaceutical in Atlanta, says the matter isn’t so straightforward.

As younger women have been encouraged to induce mammogram testing, interpreting mammograms has gotten to be a much less secure profession, he tells WebMD. Forty-year-old breasts are denser and more troublesome to “studied” than older breasts. When an anomaly appears up, however subtle it may be, more tests are requested.

Indeed, “more tests is the as it were way a radiologist can be secured from misbehavior,” he tells WebMD. “I do not believe that any radiologist has ever been sued because they called someone back for extra tests.”

In fact, radiologists turn away from mammogram testing as a claim to fame, because of negligence fears.

There are zones in the U.S. where it’s difficult to urge a mammogram at all, Brawley tells WebMD. “In Modern York City, it’s very, exceptionally troublesome because so few radiologists are willing to do it. It’s a combination of legalities and the truth that mammography doesn’t pay exceptionally well. There are a number of mammography partnership preparing programs trying to find radiologists. That’s exceptionally, very disastrous for the buyer.”

Mammogram testing is without a doubt useful, “particularly for ladies in their 50s and 60s, and shockingly we’re creating a system where it’s getting to be less and less accessible to them,” he says.

To maintain a strategic distance from getting call-backs for a moment mammogram, maintain a strategic distance from mobile vans and centers where no radiologist is on location — where the film is usually created and examined the next day after never seeing the persistent, he proposes. “Those centers don’t give as great [mammogram testing] as a center where a radiologist is on location.”

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