Treatment
Review: adequately randomised trials showed that mammography screening did not significantly reduce breast cancer, cancer, or all cause mortality but increased breast surgeries
Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev 2006;(4):CD001877.[Medline]
Q Does screening for breast cancer with mammography reduce morbidity and mortality?
Key Words: breast neoplasm • mammography
| The first 150 words of the full text of this article appear below. |
Data sources:
PubMed (June 2005) and review of reference lists.
Study selection and assessment:
randomised controlled trials (RCTs) that compared mammography screening with no mammography screening in women without previously diagnosed breast cancer. 7 trials met the selection criteria; 2 had adequate randomisation, 4 had sub-optimal randomisation, and 1 was not adequately randomised. Separate analyses were done for adequately and sub-optimally randomised trials.
Outcomes:
breast cancer mortality, cancer mortality, all cause mortality, surgical interventions, and adjuvant therapy.
Meta-analysis showed that mammography screening reduced breast cancer mortality at 7 and 13 years; however, meta-analysis of only trials with adequate randomisation found no difference between groups (table
). Groups did not differ for cancer mortality or all cause mortality (table). Mammography screening was associated with an increased risk of breast surgeries (mastectomies and lumpectomies) (table), mastectomies (table), and radiotherapy (1 trial); groups did not differ for risk of chemotherapy.
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1 Juravinski Cancer Program, Hamilton Health Sciences
2 McMaster University, School of Nursing,
Hamilton, Ontario, Canada
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