Breast screening again

The Center for Medical Consumers takes the position that as long as one team of researchers found considerable harm and uncertain benefit, it remains unclear whether symptom-free women should continue having regular mammograms. Arguably, the analysis conducted by Gotzsche and Olsen is far more in-depth and more thoroughly peer-reviewed than other analyses of the same trials. Their critics have judged the increased- mastectomy finding to be obsolete because mastectomy is no longer the only treatment for breast cancer. But Dr. Gotzsche counters that in some countries, mammography-detected carcinoma in situ is currently treated with breast removal in about one-third of all cases (Letters to The Lancet, 2/1/02). This year alone, an estimated 54,000 U.S. women will be diagnosed with carcinoma in situ, according to the American Cancer Society. Most will be treated with six weeks of radiation therapy, and some will be treated with mastectomy.