Conclusion: Mammograms Save Lives

The absolute value of mammogram screening has been debated for decades.  Opinions have run hot and cold, with supporting and undermining data pulled like arrows from quivers on every hill.  Finally, it looks like the argument has been settled – in favor of mammogram screening.

While there has been no question of the value of mammogram screening in finding breast cancer at an early stage when it is most curable and far more likely to be amenable to breast-conserving surgery and less aggressive treatment, there has been a near biblical disagreement about whether mammogram screening actually saves lives.  Further, the question repeatedly lobbed by those in charge of the pursestrings – government agencies and insurance companies – is, How many women must be screened before one life is saved?  (The unspoken question being, Is it worth it?)

To the opinion that rendered the most recent verdict:

Scientists presented a reconsideration of the literature about the value of mammogram screening at the annual meeting of the San Antonio Breast Cancer Symposium on December 11, 2013.  These scientists explained that the wide range of opinion about the absolute value of mammogram screening in preventing breast cancer deaths was largely related to the differences in study design throughout the published literature.  For instance, some studies looked only at younger women; some looked only at older women.  Some studies looked at women who were invited for mammogram screening, while other studies looked at women who were invited but who actually turned up and were screened.   Because the numerous studies conducted in the past to address this question have differed in structure and design, the conclusions drawn from their data were, necessarily, inconsistent.  That explains the confusion.  Now to sort it out:

When the scientists who presented their data in San Antonio this month re-evaluated a series of similar mammogram screening studies, they found that mammograms do indeed save lives.  They also found the that absolute value of mammogram screening (that is, how many women must be screened in order to save one life) was in the range of 64-257, well below the estimates given by other academicians (the Dartmouth group) or the federal government.

In conclusion:  Mammograms save breasts and they save lives too.

Given the overall increasing incidence of breast cancer in the world, and the increasing expense – personal and pubic – of treating this pandemic, mammogram screening appears to be a cost-effective and beneficial public health service.  So, let’s get on with it and do it.

Dr. Kathleen T. Ruddy