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Potential Hazards of Mammography

South Shore Hematology-Oncology Associates PC, Rockville Centre, NY

To the Editor:

Drs Bradbury and Olopade¹ misquote the report of the International Workshop on Screening for Breast Cancer² when they state that annual mammography "has been shown to provide a mortality benefit for women over the age of 40 years old." That workshop examined breast cancer-specific mortality and concluded that a mortality benefit for women younger than age 50 years could not be demonstrated. Breast cancer-specific mortality was improved in all trials involving women age 50 years to 70 years, but was statistically significant in only two trials. There was insufficient data on patients older than age 70 years. No trial has ever shown an overall mortality benefit from screening mammography. Thus, if there is a detrimental effect of radiation exposure from mammography, even a small effect could offset any benefit of mammography. It is also important to remember that none of the mammographic screening trials examined the effect of yearly exposure to mammography for the 20 to 30 years now recommended for most women. Although participants were followed for more than 10 years, mammograms were generally provided only for the first 5 years. It is therefore conceivable that long-term follow-up of these screening trials may not fully reflect all the potential adverse effects of mammography.

AUTHOR'S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The author indicated no potential conflicts of interest.

REFERENCES

1. Bradbury A, Olopade OI: The case for individualized screening recommendations for breast cancer. J Clin Oncol 24:3328-3329, 2006[Free Full Text]

2. Fletcher SW, Vlack W, Harris R, et al: Report of the International Workshop on Screeening for Breast Cancer. J Natl Cancer Inst 85:1644-1656, 1993[Abstract/Free Full Text]

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