In January 2013, the Swiss Medical Board was authorized to prepare a mammography report. The council included a medical ethics specialist, a clinical epidemiologist, a clinical pharmacologist, a surgeon, an oncologist, a nurse scientist, a lawyer, and a health economist.
Two council members – Nikola Biller-Andorno, M.D. Ph.D. and Peter Juni, M.D. – shared their view in the New England Journal of Medicine, saying: “As we can see in the project, we know the controversies surrounding the issue of mammography over the past 10-15 years.
When we got the evidence available and we calculated their complications in detail, however, we were worried. ” The negatives of over-diagnosis
Doctors explained that they were shocked to find so little evidence that mammography positive outgrew negatives. “The relative risk reduction of approximately 20% in breast cancer-related mortality associated with mammography, which has been described by most experts, has brought with it an important diagnostic catarrhal, with repeat mammograms, biopsies one after the other, and overdosing of breast cancers – cancers that would never have been clinically perceived. ”
According to a 25-year Canadian Mammography Center study, 106 of the 484 malignancies detected by mammography had been overdrive, reaching 21.9%. The doctors of the council explained. “This means that 106 of the 44,925 healthy women in the mammography group were diagnosed and treated for breast cancer without need, resulting in unnecessary surgeries, radiotherapy, chemotherapy or a combination of these.”
Positive mammography is overestimated
An additional 10 trials with 600,000 women did not show that mammography affected mortality, which raises questions about the benefits of mammography. A survey of women’s views in the United States found that 71.5% of women said they believed mammography reduced the risk of death from breast cancer by at least half, and 72.1% believed that at least 80 deaths could be prevented 1,000 mammography women.
See true figures: mammography reduces the risk by 20% and can prevent 1 death per 1,000 women being examined. The Swiss Medical Council focused on the alarming difference in numbers. They wonder how women can make a thorough decision if they overestimate so much the benefits of mammography.
Their report was published on 2 February 2014. They acknowledged that there was no evidence to suggest that mammography affected the overall mortality rate and highlighted the negatives of false positives and the risk of overdiagnosis.
Let’s take a look at the numbers. For any death from breast cancer prevented in the US over a 10-year period with annual mammography examinations starting at the age of 50:
490-670 women are likely to receive false positive mammography by repeat testing
70-100 women are likely to have a biopsy without any reason
3-14 women were diagnosed with breast cancer that would never be clinically perceived.
A last sentence
The Council’s proposal is that there should be no systematic mammography programs and a time limit for the existing programs. In addition, they said that the quality of all mammograms should be assessed and clear information should be given to women about the advantages and disadvantages of mammography.
The Council’s proposals are not legally binding, but the petition has not been found by many experts and organizations in Switzerland. According to the doctors of the council, “One of the main arguments used against it is that it was in contradiction with the global view prevailing among the experts in this field.
Another argument was that the report worried women, but we are wondering how we can avoid it on the basis of the data we have. “