Annals of Internal Medicine | 2019
Screening for Breast Cancer in Average-Risk Women
Abstract
TO THE EDITOR: The American College of Physicians (ACP) guidance statement on screening for breast cancer in average-risk women (1) concludes that the potential harms of screening for breast cancer with mammography before age 50 years outweigh the benefits in most women. Among the chief harms of screening that ACP cites are distress, anxiety, and worry. Women should know that these harms must be measured against evidence accrued over decades that proves that mammography saves lives in women aged 40 to 49 years. Randomized controlled trials show a reduction in breast cancer deaths for women in this age group who participate in screening (2). This fact is corroborated by such observational studies as the recent Pan-Canadian study, which showed a 44% reduction in breast cancer deaths among women aged 40 to 49 years who were screened (3). Webb and colleagues recent study (4) concluded that approximately 70% of breast cancer deaths among women in their 40s occurred in the 20% who did not receive screening. To discourage a woman from breast cancer screening in order to reduce stress is faulty logic at best.